Dr Lida Davani DDS Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR LIDA DAVANI DDS DENTAL CORP

Practice address

8540 S Sepulveda Blvd Ste 815
Los Angeles, CA 90045-3808

Phone

(310) 410-9470

NPI assigned

Mar 11, 2024

Last updated

Mar 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lida Mohaghegh-Davani, DDSNPI 1437206331

Title

Owner/ Provider

Phone

(310) 410-9470

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lida Mohaghegh Davani, D.D.S

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1437206331
  NPD Authorized official
• James R. Tate

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1013037878
  NPD (past)

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1063270411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD STE 815",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453808",
            "telephone_number": "310-410-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD STE 815",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453808",
            "telephone_number": "310-410-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LIDA DAVANI DDS DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "MOHAGHEGH-DAVANI",
        "authorized_official_first_name": "LIDA",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "310-410-9470",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.