NPIMap

Organization Active NPI

Nima Ebrahimi, D.D.S., Inc.

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1013658210
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
NIMA EBRAHIMI, D.D.S., INC.
Practice address
11645 Wilshire Blvd Ste 1001
Los Angeles, CA 90025-6808
Phone
(310) 620-8140
NPI assigned
Apr 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Dr. Nima Ebrahimi, D.D.S.NPI 1639488034
Title
Owner
Phone
(818) 404-7111

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

11645 Wilshire Blvd Ste 1001
Los Angeles, CA 90025-6808

Mailing address

11645 Wilshire Blvd Ste 1001
Los Angeles, CA 90025-6808
Phone (310) 620-8140

National Provider Directory

National Provider Directory

Locations

11645 Wilshire Blvd
Ste 1001
West Los Angeles, CA 90025
Phone (310) 620-8140

Practitioners & affiliated clinicians

Practitioners 1

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": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1013658210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-620-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-620-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIMA EBRAHIMI, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI",
        "authorized_official_first_name": "NIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-404-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.