NPIMap

Organization Active NPI

Kathy Maasoumi D.D.S Inc.

  • Dentist
  • Lake Forest, CA
National Provider Identifier
1033236484
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41949 Issued in CA
Legal business name
KATHY MAASOUMI D.D.S INC.
Practice address
22706 Aspan St
Suite 602
Lake Forest, CA 92630-1603
Phone
(949) 716-7000
Fax
(949) 716-0600
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Authorized official

Name
Dr. Kathy Maasoumi, DDS
Title
Owner
Phone
(949) 716-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 41949 CA Primary

Addresses

Primary practice location

22706 Aspan St
Suite 602
Lake Forest, CA 92630-1603

Mailing address

22706 Aspan St
Suite 602
Lake Forest, CA 92630-1603
Phone (949) 716-7000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415923200000",
    "number": "1033236484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22706 ASPAN ST",
            "address_2": "SUITE 602",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301603",
            "telephone_number": "949-716-7000",
            "fax_number": "949-716-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22706 ASPAN ST",
            "address_2": "SUITE 602",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301603",
            "telephone_number": "949-716-7000",
            "fax_number": "949-716-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHY MAASOUMI D.D.S INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-11-14",
        "status": "A",
        "authorized_official_last_name": "MAASOUMI",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-716-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.