Individual provider Active NPI

Kamran Yazdi, DDS

  • General Practice Dentistry
  • Torrance, CA
National Provider Identifier
1013134477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41151 Issued in CA
Practice address
23560 Madison St
Suite 208
Torrance, CA 90505-4708
Phone
(310) 530-9884
Fax
(310) 530-1918
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41151 CA Primary

Addresses

Primary practice location

23560 Madison St
Suite 208
Torrance, CA 90505-4708

Mailing address

23560 Madison St
Suite 208
Torrance, CA 90505-4708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504001751 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153620604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41151CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013134477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23560 MADISON ST",
            "address_2": "SUITE 208",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23560 MADISON ST",
            "address_2": "SUITE 208",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054708",
            "telephone_number": "310-530-9884",
            "fax_number": "310-530-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZDI",
        "first_name": "KAMRAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.