Individual provider Active NPI

Parisa Gheidarpour, D.D.S.

  • Dentist
  • Rancho Cucamonga, CA
National Provider Identifier
1073927935
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63475 Issued in CA
Practice address
8599 Haven Ave Ste 105
Rancho Cucamonga, CA 91730-4849
Phone
(909) 945-2342
Fax
(909) 948-5474
NPI assigned
Jun 18, 2014
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63475 CA Primary

Addresses

Primary practice location

8599 Haven Ave Ste 105
Rancho Cucamonga, CA 91730-4849

Mailing address

8599 Haven Ave Ste 105
Rancho Cucamonga, CA 91730-4849
Phone (909) 254-7032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
63475CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Parisa Dental Group Inc CurrentSince Feb 26, 2023 Accepting new patients
Hugh D Burke Jr DDS Inc. Dentist CurrentSince Feb 19, 2023 Accepting new patients

Locations

8599 Haven Ave
Ste 105
Rancho Cucamonga, CA 91730
Phone (909) 945-2342

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1073927935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8599 HAVEN AVE STE 105",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304849",
            "telephone_number": "909-254-7032",
            "fax_number": "909-948-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8599 HAVEN AVE STE 105",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304849",
            "telephone_number": "909-945-2342",
            "fax_number": "909-948-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEIDARPOUR",
        "first_name": "PARISA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.