Individual provider Active NPI

Tamara Ayoub, DDS

  • Dentist
  • Rolling Hills, CA
National Provider Identifier
1942679733
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64752 Issued in CA
Practice address
3 Hummingbird LN
Rolling Hills, CA 90274-5229
Phone
(310) 940-4234
NPI assigned
Sep 22, 2015
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64752 CA Primary

Addresses

Primary practice location

3 Hummingbird LN
Rolling Hills, CA 90274-5229

Mailing address

3 Hummingbird LN
Rolling Hills, CA 90274-5229

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
I20161021000822 CA Order and Referring Only - DentistPractitioner - Dentist 6608154984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64752CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1942679733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HUMMINGBIRD LN",
            "city": "ROLLING HILLS",
            "state": "CA",
            "postal_code": "902745229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HUMMINGBIRD LN",
            "city": "ROLLING HILLS",
            "state": "CA",
            "postal_code": "902745229",
            "telephone_number": "310-940-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills, CA

Sources for this page

Verify at the official NPI Registry.