NPIMap

Organization Active NPI

Behzad Shirazi Ardestani Inc a Professional Dental Corporation

  • Dental Clinic/Center
  • Burbank, CA
National Provider Identifier
1003082074
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BEHZAD SHIRAZI ARDESTANI INC A PROFESSIONAL DENTAL CORPORATION
Practice address
500 E Olive Ave
430
Burbank, CA 91501-3316
Phone
(818) 567-4662
Fax
(818) 567-0554
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Authorized official

Name
Dr. Behzad Shirazi ArdestaniNPI 1346461407
Title
Owner
Phone
(818) 567-4662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

500 E Olive Ave
430
Burbank, CA 91501-3316

Mailing address

500 E Olive Ave
430
Burbank, CA 91501-3316
Phone (818) 567-4662

Other identifiers 1

IdentifierTypeStateIssuer
G91547-01MedicaidCA

Other names 1

  • Burbank/Glendale Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

500 E Olive Ave
Ste 430
Burbank, CA 91501
Phone (818) 515-4012

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1003082074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE",
            "address_2": "430",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013316",
            "telephone_number": "818-567-4662",
            "fax_number": "818-567-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE",
            "address_2": "430",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013316",
            "telephone_number": "818-567-4662",
            "fax_number": "818-567-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHZAD SHIRAZI ARDESTANI INC A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "SHIRAZI ARDESTANI",
        "authorized_official_first_name": "BEHZAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-567-4662",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G91547-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burbank/Glendale Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.