Active NPI
Aminollah Sadeghi
- Dentist
- Fresno, CA
National Provider Identifier
1992843643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50519
- Practice address
- 125 E Barstow Ave Ste 122
Fresno, CA 93710-5023 - Phone
- (559) 229-6249
- Fax
- (559) 369-7176
- NPI assigned
- Feb 2, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 50519 | CA | Primary |
Addresses
Primary practice location
125 E Barstow Ave Ste 122
Fresno, CA 93710-5023
Mailing address
840 E Country View Cir
Fresno, CA 93720-0725
Phone (559) 229-6249
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D50519 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160427001114 | CA | Order and Referring Only - Dentist | 2961701842 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50519 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Clovis, CA
- NPI 1770630170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1992843643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 E COUNTRY VIEW CIR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937200725",
"telephone_number": "559-229-6249",
"fax_number": "559-369-7176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 E BARSTOW AVE STE 122",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105023",
"telephone_number": "559-229-6249",
"fax_number": "559-369-7176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SADEGHI",
"first_name": "AMINOLLAH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2021-12-20",
"certification_date": "2021-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "50519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D50519",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.