Individual provider Active NPI

Shahin Javid, DDS

  • Dentist
  • Valencia, CA
National Provider Identifier
1053440156
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
43021 Issued in CA
Practice address
27335 Tourney Rd Suite 100
Valencia, CA 91355-2200
Phone
(661) 222-2242
Fax
(661) 222-2236
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X BJ4608709 CA
Dentist 122300000X 43021 CA Primary

Addresses

Primary practice location

27335 Tourney Rd Suite 100
Valencia, CA 91355-2200

Mailing address

27335 Tourney Rd Suite 100
Valencia, CA 91355-2200
Phone (661) 222-2242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200324000462 CA Practitioner - Oral SurgeryPractitioner - Dentist 9234358151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Sleep Services Inc Dentist PastSince Apr 23, 2014 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1053440156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27335 TOURNEY RD SUITE 100",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552200",
            "telephone_number": "661-222-2242",
            "fax_number": "661-222-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27335 TOURNEY RD SUITE 100",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552200",
            "telephone_number": "661-222-2242",
            "fax_number": "661-222-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVID",
        "first_name": "SHAHIN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2024-09-26",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "BJ4608709",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.