Active NPI
Bobby Ghandehari, DDS, MS,
- Orthodontics and Dentofacial Orthopedics Dentistry
- Laguna Hills, CA
National Provider Identifier
1922146349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 45367
- Practice address
- 24422 Avenida de la Carlota
Suite 120
Laguna Hills, CA 92653 - Phone
- (949) 305-0550
- Fax
- (949) 305-0551
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 45367 | CA | Primary |
Addresses
Primary practice location
24422 Avenida de la Carlota
Suite 120
Laguna Hills, CA 92653
Mailing address
24422 Avenida de la Carlota
Suite 120
Laguna Hills, CA 92653
Phone (949) 305-0550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45367 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah I. Mathias DDS, Ms, PC | 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 and National Provider Directory roles.
-
- Dentist
- Laguna Hills, CA
- NPI 1083000236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427068800000",
"number": "1922146349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24422 AVENIDA DE LA CARLOTA",
"address_2": "SUITE 120",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "92653",
"telephone_number": "949-305-0550",
"fax_number": "949-305-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24422 AVENIDA DE LA CARLOTA",
"address_2": "SUITE 120",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "92653",
"telephone_number": "949-305-0550",
"fax_number": "949-305-0551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHANDEHARI",
"first_name": "BOBBY",
"name_prefix": "Dr.",
"credential": "DDS, MS,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2015-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "45367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.