Individual provider Active NPI

Homa Daryaei, DDS

  • General Practice Dentistry
  • Sun Valley, CA
National Provider Identifier
1073662466
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53589 Issued in CA
Practice address
8052 Vineland Ave Ste 109
Sun Valley, CA 91352-5513
Phone
(818) 504-2899
Fax
(818) 504-2899
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53589 CA Primary

Addresses

Primary practice location

8052 Vineland Ave Ste 109
Sun Valley, CA 91352-5513

Mailing address

1435 N Pacific Ave
Glendale, CA 91202-1656
Phone (818) 243-6091

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
I20151026000157 CA Order and Referring Only - DentistPractitioner - Dentist 0547579963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: hdaryaei@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1073662466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N PACIFIC AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912021656",
            "telephone_number": "818-243-6091",
            "fax_number": "818-243-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8052 VINELAND AVE STE 109",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913525513",
            "telephone_number": "818-504-2899",
            "fax_number": "818-504-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARYAEI",
        "first_name": "HOMA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Valley, CA

Sources for this page

Verify at the official NPI Registry.