Active NPI
Mirzaei Dental Corporation
- General Practice Dentistry
- San Bernardino, CA
National Provider Identifier
1043035975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MIRZAEI DENTAL CORPORATION
- Practice address
- 1353 W Mill St Ste 114
San Bernardino, CA 92410-2224 - Phone
- (805) 914-4495
- NPI assigned
- Nov 16, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- May Mirzaei
- Title
- DDS
- Phone
- (805) 914-4495
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 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | |||
| Endodontics | 1223E0200X | |||
| General Practice Dentistry | 1223G0001X | Primary | ||
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | |||
| Pediatric Dentistry | 1223P0221X | |||
| Periodontics | 1223P0300X | |||
| Prosthodontics | 1223P0700X | |||
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | |||
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | |||
| Orofacial Pain Dentistry | 1223X2210X | |||
| Dental Hygienist | 124Q00000X | |||
| Dental Assistant | 126800000X | |||
| Dental Laboratory Technician | 126900000X |
Addresses
Primary practice location
1353 W Mill St Ste 114
San Bernardino, CA 92410-2224
Mailing address
37 Mirador
Irvine, CA 92612-2979
National Provider Directory
National Provider DirectoryPractitioners & 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": "1731715200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731715200000",
"number": "1043035975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 MIRADOR",
"city": "IRVINE",
"state": "CA",
"postal_code": "926122979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1353 W MILL ST STE 114",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924102224",
"telephone_number": "805-914-4495"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIRZAEI DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-16",
"last_updated": "2024-11-16",
"certification_date": "2024-11-16",
"status": "A",
"authorized_official_last_name": "MIRZAEI",
"authorized_official_first_name": "MAY",
"authorized_official_title_or_position": "DDS",
"authorized_official_telephone_number": "805-914-4495"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Dental Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0106X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Prosthodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0008X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X2210X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orofacial Pain",
"state": null,
"license": null,
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": false
},
{
"code": "126800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "126900000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Laboratory Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.