DRS Siamak Khakshooy and Soheil Vahedi DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

54735 Issued in CA

Legal business name

DRS SIAMAK KHAKSHOOY AND SOHEIL VAHEDI DDS INC

Practice address

3451 W Century Blvd Ste B1
Inglewood, CA 90303-1228

Phone

(310) 330-9000

Fax

(310) 330-9303

NPI assigned

Oct 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Soheil Vahedi, DDSNPI 1306982335

Title

Owner

Phone

(310) 775-5225

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Aesthetica Dental Group Doing business as

Practitioners 1

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

• Soheil Vahedi, D.D.S.

  • Dentist
  • Inglewood, CA
  • NPI 1306982335
  NPD Authorized official

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1003191123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD STE B1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031228",
            "telephone_number": "310-330-9000",
            "fax_number": "310-330-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD STE B1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031228",
            "telephone_number": "310-330-9000",
            "fax_number": "310-330-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS SIAMAK KHAKSHOOY AND SOHEIL VAHEDI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "VAHEDI",
        "authorized_official_first_name": "SOHEIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-775-5225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54735",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54539",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "1306982335",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "1750437109",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetica Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Inglewood, CA
• Providers in Inglewood, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.