Individual provider Active NPI

Afaf Ezzat Iskander, DDS

  • General Practice Dentistry
  • Pasadena, CA
National Provider Identifier
1891856589
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43171 Issued in CA
Practice address
709 N Lake Ave
Pasadena, CA 91104-4558
Phone
(626) 797-8900
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43171 CA Primary

Addresses

Primary practice location

709 N Lake Ave
Pasadena, CA 91104-4558

Mailing address

1526 Sinaloa Ave
Pasadena, CA 91104-2744
Phone (626) 398-7791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909003255 CA Order and Referring Only - DentistPractitioner - Dentist 3678880515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43171CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maverick Bani, D.D.S., Inc. PastSince Sep 8, 2024 Accepting new patients
Lakeview Dental Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: aiskander@direct.westerndental.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1891856589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 SINALOA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042744",
            "telephone_number": "626-398-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N LAKE AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911044558",
            "telephone_number": "626-797-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKANDER",
        "first_name": "AFAF",
        "middle_name": "EZZAT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.