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Active NPI 1427735539 Individual Practitioner Male Practitioner

Javad Haydari

Dentist - General Practice • Bloomington, CA

Professional Overview & Biography Verified Profile Summary

Javad Haydari is a registered healthcare professional specializing in Dentist - General Practice in Bloomington, CA. Practice services are available at 17644 VALLEY BLVD STE 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

17644 Valley Blvd Ste 1

Bloomington, CA 923163908

Telephone 9093286787

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bloomington, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
3 Specialists

Practicing in Bloomington, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-09
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 109171

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Neha Shah

Dentist - General Practice

NPI 1336601756

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location October 09, 2024

Registered at 17644 VALLEY BLVD STE 1, BLOOMINGTON, CA 923163908 (Tel: 9093286787)

📍
Updated Business Mailing Address October 09, 2024

Registered at 9350 THE RESORT PKWY UNIT 1513, RANCHO CUCAMONGA, CA 917309221 (Tel: 7204128347)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 23, 2023

Dentist (License #109171 in CA)

NPI Profile Active June 30, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location June 30, 2023

Registered at 9610 SIERRA AVE, FONTANA, CA 923352452 (Tel: 9092198700)

📍
Updated Business Mailing Address June 30, 2023

Registered at 1141 W 37TH ST, LOS ANGELES, CA 900073953 (Tel: 7204128347)

👤
Provider Name / Credentials Updated June 30, 2023

Recorded as JAVAD HAYDARI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 30, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 30, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1427735539
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2023
Last Update: October 09, 2024
Sole Proprietor: Yes

Mailing Address

9350 The Resort Pkwy Unit 1513

Rancho Cucamonga, CA 917309221

Phone: 7204128347

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.