E. Benji Behroozan DDS Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

31568 Issued in CA

Legal business name

E. BENJI BEHROOZAN DDS INC.

Practice address

2221 Lincoln Blvd # 200
Santa Monica, CA 90405-1320

Phone

(310) 399-1100

Fax

(310) 664-8901

NPI assigned

Sep 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ehteram Benji Behroozan, DDS

Title

Owner

Phone

(310) 399-1100

Specialties & licenses 1

Addresses

Tax ID family

E Benji Behroozan DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• E. Benji Behroozan DDS Inc.

  • Dentist
  • Los Angeles, CA
  • NPI 1225346919
  NPD tax ID

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1003124702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD # 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-399-1100",
            "fax_number": "310-664-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 LINCOLN BLVD # 200",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051320",
            "telephone_number": "310-399-1100",
            "fax_number": "310-664-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. BENJI BEHROOZAN DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "BENJI BEHROOZAN",
        "authorized_official_first_name": "EHTERAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-399-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "31568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.