Individual provider Active NPI

Irina M Sahaki, DDS

  • General Practice Dentistry
  • Glendale, CA
National Provider Identifier
1912179904
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43491 Issued in CA
Practice address
520 East Broadway
Suite #402
Glendale, CA 91205
Phone
(818) 241-2424
Fax
(818) 241-4646
NPI assigned
Mar 31, 2008
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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 43491 CA Primary

Addresses

Primary practice location

520 East Broadway
Suite #402
Glendale, CA 91205

Mailing address

5420 Syemon Av
#223
Van Nuys, CA 91401
Phone (818) 786-6016

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
I20160329001203 CA Order and Referring Only - DentistPractitioner - Dentist 2860799376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43491CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Irina M. Sahaki DDS, Inc. Past Accepting new patients

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, 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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1912179904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 SYEMON AV",
            "address_2": "#223",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-786-6016",
            "fax_number": "818-786-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 EAST BROADWAY",
            "address_2": "SUITE #402",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-241-2424",
            "fax_number": "818-241-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAKI",
        "first_name": "IRINA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.