Sam Tehrani, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS102750 Issued in CA

Practice address

3297 Arlington Ave Ste 101
Riverside, CA 92506-3250

Phone

(951) 683-6055

NPI assigned

Jul 21, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nguyen and Watanabe Dental Corporation

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1326131517
  NPD (past)

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532131200000",
    "number": "1982181012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 GARLAND CT",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952317",
            "telephone_number": "925-899-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 ARLINGTON AVE STE 101",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063250",
            "telephone_number": "951-683-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEHRANI",
        "first_name": "SAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-21",
        "last_updated": "2018-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lina Liswaldy Tedja-Lee, PHARM.D.
• Yudi Tedjakusnadi, DDS
• Destiny Jean Tedtaotao
• Miriam E Teele
• Gail June Tehan, L.V.N.
• Sergio Gerardo Tejada, P.T.A.
• Rigoberto Tejeda Acevedo, M.D.
• Jasmine Ortiz Tejeiro
• Telecare Corporation
• Telecare Corporation

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.