Individual provider Active NPI

Bedan Obar Meimban, DDS

  • Dentist
  • Fresno, CA
National Provider Identifier
1902063498
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56974 Issued in CA
Practice address
2000 Fresno St
Ste 300
Fresno, CA 93721-1708
Phone
(559) 442-1100
NPI assigned
May 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56974 CA Primary

Addresses

Primary practice location

2000 Fresno St
Ste 300
Fresno, CA 93721-1708

Mailing address

397 E Marwood LN
Fresno, CA 93720-0840
Phone (707) 256-9152

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
I20180612003274 CA Order and Referring Only - DentistPractitioner - Dentist 0547515702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56974CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Dental Services Dentist Past Accepting new patients

Interoperability endpoints

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

Organizations & group practices 1

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1902063498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 E MARWOOD LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200840",
            "telephone_number": "707-256-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FRESNO ST",
            "address_2": "STE 300",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211708",
            "telephone_number": "559-442-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIMBAN",
        "first_name": "BEDAN",
        "middle_name": "OBAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.