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ROHIN AMBARAM
NPI 1457747123
Dentist - Oral and Maxillofacial Surgery in Tarzana, CA

Active since April 09, 2015Opted out of Medicare · through Jul 19, 2028
19100 VENTURA BLVD STE 3, TARZANA, CA 91356(916) 517-3481 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jun 28, 2021, Jun 4, 2021 (2 updates tracked since 2021).

About Rohin Ambaram NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROHIN AMBARAM (NPI 1457747123) is an individual oral and maxillofacial surgery provider in Tarzana, California, licensed in California (100021) and active in the NPI registry since April 2015. He has opted out of Medicare through July 19, 2028 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1457747123
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameROHIN AMBARAM
Location Address19100 VENTURA BLVD STE 3Tarzana, CA 91356-3234
Mailing Address18 Autumn Leaf DrThousand Oaks, CA 91360-2607 · (916) 517-3481
Phone(916) 517-3481
Sole ProprietorYes
Enumeration DateApril 9, 2015
Last NPPES UpdateJune 28, 20212 updates tracked since enumeration
NPPES CertifiedJune 28, 2021
✔ NPI 1457747123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · 100021
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
19100 VENTURA BLVD STE 3, Tarzana, CA 91356
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1Park Place Dental Group, 501 S Reino Rd, Ste GNewbury Park, CA 91320 · Phone (805) 499-4441
Location 24201 Saint Antoine St, UHC 2FDetroit, MI 48201-2153 · Phone (313) 745-4622

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Rohin Ambaram has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 19, 2024 through July 19, 2028.

Opt-Out Effective DateJuly 19, 2024
Opt-Out In Effect ThroughJuly 19, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91356 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONA DERENTZ D.D.S., INC
Dentist (Orthodontics and Dentofacial Orthopedics)
19100 VENTURA BLVD STE 3
TARZANA, CA 91356
Los Angeles County (818) 925-2599

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rohin Ambaram's NPI number?

The NPI number for Rohin Ambaram is 1457747123. It was assigned to this individual provider in the NPPES registry on April 9, 2015.

Where is Rohin Ambaram located?

Rohin Ambaram practices at 19100 Ventura Blvd Ste 3, Tarzana, CA 91356. The listed phone number is (916) 517-3481.

What is Rohin Ambaram's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Rohin Ambaram enrolled in Medicare?

No. Rohin Ambaram has opted out of Medicare through July 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Rohin Ambaram accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Rohin Ambaram as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rohin Ambaram was last updated on June 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.