Individual provider Active NPI

Sam Siamak Markzar, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Beverly Hills, CA
National Provider Identifier
1891906624
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
41954 Issued in CA
Practice address
8500 Wilshire Blvd
Suite 819
Beverly Hills, CA 90211
Phone
(310) 360-7570
Fax
(310) 360-1098
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 41954 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 41954 CA Primary

Addresses

Primary practice location

8500 Wilshire Blvd
Suite 819
Beverly Hills, CA 90211

Mailing address

18156 E Colima Road
Rowland Heights, CA 91748
Phone (626) 965-0971

Other names 1

  • Dr. Sam Siamak Marghzar Other name

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
I20170607000236 CA Practitioner - Oral Surgery 6406123884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41954CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kerry Lee DDS Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1891906624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18156 E COLIMA ROAD",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "91748",
            "telephone_number": "626-965-0971",
            "fax_number": "626-965-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD",
            "address_2": "SUITE 819",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90211",
            "telephone_number": "310-360-7570",
            "fax_number": "310-360-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKZAR",
        "first_name": "SAM",
        "middle_name": "SIAMAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "41954",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "41954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "MARGHZAR",
            "middle_name": "SIAMAK",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.