Individual provider Active NPI

Peiman Soleymani, D.D.S.

  • Periodontics
  • Beverly Hills, CA
National Provider Identifier
1063856672
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
44444 Issued in CA
Practice address
416 N Bedford Dr
Suite 209
Beverly Hills, CA 90210-4322
Phone
(310) 275-4606
Fax
(310) 623-9106
NPI assigned
Apr 25, 2013
Reactivated
Jul 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 44444 CA Primary

Addresses

Primary practice location

416 N Bedford Dr
Suite 209
Beverly Hills, CA 90210-4322

Mailing address

416 N Bedford Dr
Suite 209
Beverly Hills, CA 90210-4322
Phone (310) 275-4606

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170213002645 CA Order and Referring Only - Other (Non-Physician) 6103109368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44444CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Peiman Soleymani DDS Inc Periodontics Past 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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1063856672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 209",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-275-4606",
            "fax_number": "310-623-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 209",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-275-4606",
            "fax_number": "310-623-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLEYMANI",
        "first_name": "PEIMAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-07-25",
        "deactivation_date": "2013-06-05",
        "reactivation_date": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "44444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.