Active NPI
Tony Ammar Sayegh, D.D.S
- Dentist
- Glendora, CA
National Provider Identifier
1972628048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 31975
- Practice address
- 102 W Route 66
#G
Glendora, CA 91740-6247 - Phone
- (626) 335-1241
- Fax
- (626) 335-1241
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 31975 | CA | Primary |
Addresses
Primary practice location
102 W Route 66
#G
Glendora, CA 91740-6247
Mailing address
102 W Route 66
#G
Glendora, CA 91740-6247
Phone (626) 335-1241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B31975 01 | Medicaid | CA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31975 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1972628048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 W ROUTE 66",
"address_2": "#G",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406247",
"telephone_number": "626-335-1241",
"fax_number": "626-335-1241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 W ROUTE 66",
"address_2": "#G",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406247",
"telephone_number": "626-335-1241",
"fax_number": "626-335-1241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAYEGH",
"first_name": "TONY",
"middle_name": "AMMAR",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "31975",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "B31975 01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.