Active NPI
Seyyedhossein Mousavi
- Dentist
- Canoga Park, CA
National Provider Identifier
1033625181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102218
- Practice address
- 22030 Sherman Way Ste 219
Canoga Park, CA 91303-1855 - Phone
- (424) 644-1646
- NPI assigned
- Dec 26, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 102218 | CA | |
| Dentist | 122300000X | 102218 | CA | Primary |
Addresses
Primary practice location
22030 Sherman Way Ste 219
Canoga Park, CA 91303-1855
Mailing address
45377 Palmwood Dr
Indio, CA 92201-5112
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102218 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1033625181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45377 PALMWOOD DR",
"city": "INDIO",
"state": "CA",
"postal_code": "922015112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22030 SHERMAN WAY STE 219",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031855",
"telephone_number": "424-644-1646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSAVI",
"first_name": "SEYYEDHOSSEIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-26",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "102218",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.