Active NPI
Maryam Haeri Maybodi, D.D.S
- General Practice Dentistry
- Laguna Niguel, CA
National Provider Identifier
1083637425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 49193
- Practice address
- 30101 Town Center Dr Ste 205
Laguna Niguel, CA 92677-2065 - Phone
- (949) 295-0940
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 49193 | CA | Primary |
Addresses
Primary practice location
30101 Town Center Dr Ste 205
Laguna Niguel, CA 92677-2065
Mailing address
30025 Alicia Pkwy # B231
Laguna Niguel, CA 92677-2090
Phone (949) 295-0940
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49193 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083637425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30025 ALICIA PKWY # B231",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772090",
"telephone_number": "949-295-0940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30101 TOWN CENTER DR STE 205",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926772065",
"telephone_number": "949-295-0940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAERI MAYBODI",
"first_name": "MARYAM",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "49193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Niguel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.