Individual provider Active NPI

Farid Baradaran Nakhjavani, DMD

  • Dentist
  • Santa Ana, CA
National Provider Identifier
1023680600
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
106506 Issued in CA
Practice address
2701 W 1St St
Santa Ana, CA 92703-3443
Phone
(512) 277-0025
NPI assigned
Jul 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 106506 CA Primary

Addresses

Primary practice location

2701 W 1St St
Santa Ana, CA 92703-3443

Mailing address

187 Pineview
Irvine, CA 92620-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1023680600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 PINEVIEW",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W 1ST ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033443",
            "telephone_number": "512-277-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARADARAN NAKHJAVANI",
        "first_name": "FARID",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.