Individual provider Active NPI

Alexander S Moradzadeh, D.D.S

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1063677870
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57506 Issued in CA
Practice address
2206 S Figueroa St
Los Angeles, CA 90007-2049
Phone
(213) 748-8448
Fax
(213) 749-5569
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CA
General Practice Dentistry 1223G0001X 57506 CA Primary

Addresses

Primary practice location

2206 S Figueroa St
Los Angeles, CA 90007-2049

Mailing address

2206 S Figueroa St
Los Angeles, CA 90007-2049
Phone (213) 748-8448

Other names 1

  • Dr. Alexander S Moradzadeh Other name

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
I20151123001023 CA Order and Referring Only - DentistPractitioner - Dentist 0840590998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57506CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Alexander S Moradzadeh DDS Inc General Practice CurrentSince Jul 24, 2022 Accepting new patients
Moradzadeh DDS Inc CurrentSince Dec 15, 2024 Accepting new patients

Locations

2206 S Figueroa St
Los Angeles, CA 90007
Phone (213) 748-8448

Organizations & group practices 2

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1063677870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 S FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072049",
            "telephone_number": "213-748-8448",
            "fax_number": "213-749-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 S FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072049",
            "telephone_number": "213-748-8448",
            "fax_number": "213-749-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORADZADEH",
        "first_name": "ALEXANDER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDER",
            "last_name": "MORADZADEH",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.