Individual provider Active NPI

Pejman Parsa, DDS , MS

  • Endodontics
  • Los Angeles, CA
National Provider Identifier
1063725638
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
59508 Issued in CA
Practice address
10921 Wilshire Blvd Ste 1203
Los Angeles, CA 90024-4005
Phone
(424) 369-5160
Fax
(424) 232-8458
NPI assigned
Jul 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 59508 CA Primary

Addresses

Primary practice location

10921 Wilshire Blvd Ste 1203
Los Angeles, CA 90024-4005

Mailing address

10921 Wilshire Blvd Ste 1203
Los Angeles, CA 90024-4005
Phone (424) 369-5160

Other practice location 1

5836 Nevada Ave
Woodland Hills, CA 91367-4527
Phone (818) 261-8909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160527001798 TX Order and Referring Only - DentistPractitioner - Dentist 8527358878
I20160608001698 NY Order and Referring Only - DentistPractitioner - Dentist 8527358878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
59508CAMDEndodontist
057873NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Parsa Endodontics Dental Group PC Endodontics CurrentSince Jul 24, 2022 Accepting new patients

Locations

10921 Wilshire Blvd
Ste 1203
Los Angeles, CA 90024
Phone (310) 208-6049

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063725638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 1203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244005",
            "telephone_number": "424-369-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 1203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244005",
            "telephone_number": "424-369-5160",
            "fax_number": "424-232-8458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5836 Nevada Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913674527",
            "country_code": "US",
            "telephone_number": "818-261-8909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARSA",
        "first_name": "PEJMAN",
        "name_prefix": "Dr.",
        "credential": "DDS , MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "59508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.