Mitra Mashreghi, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

55376 Issued in CA

Practice address

4789 Vineland Ave
# 202
North Hollywood, CA 91602-3518

Phone

(818) 980-1200

Fax

(818) 980-1233

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mitra Mashreghi DMD Dental Corporation

  • Dentist
  • Los Angeles, CA
  • NPI 1932455631
  Medicare reassignment NPD Authorized official
• Alex Gladkov, DDS

  • Dentist
  • Culver City, CA
  • NPI 1902921554
  NPD (past)
• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1073729232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 VINELAND AVE",
            "address_2": "# 202",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916023518",
            "telephone_number": "818-980-1200",
            "fax_number": "818-980-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 VINELAND AVE",
            "address_2": "# 202",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916023518",
            "telephone_number": "818-980-1200",
            "fax_number": "818-980-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHREGHI",
        "first_name": "MITRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Homes LLC
• Masa Comfort Living Inc
• Masa Comfort Living Inc.
• Mashreghi DMD Dental Corporation
• Alireza Mashreghi, D.D.S
• Jaklin Ana Masoudi
• Haig Mastikian, DMD
• Naje Maszewski
• Dayna Dewitt Mataisz, PMHNP
• Michael Matherne, O.D.

• Dentist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.