Active NPI
James Mahooti, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1063628022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33803
- Practice address
- 9450 Scranton Rd
Suite 109
San Diego, CA 92121-4720 - Phone
- (858) 457-8514
- Fax
- (858) 457-5801
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 33803 | CA | Primary |
Addresses
Primary practice location
9450 Scranton Rd
Suite 109
San Diego, CA 92121-4720
Mailing address
9450 Scranton Rd
Suite 109
San Diego, CA 92121-4720
Phone (858) 457-8514
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 |
|---|---|---|---|
| 33803 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063628022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9450 SCRANTON RD",
"address_2": "SUITE 109",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921214720",
"telephone_number": "858-457-8514",
"fax_number": "858-457-5801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9450 SCRANTON RD",
"address_2": "SUITE 109",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921214720",
"telephone_number": "858-457-8514",
"fax_number": "858-457-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHOOTI",
"first_name": "JAMES",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "33803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.