Individual provider Active NPI

Arash S Fard

  • Dentist
  • Culver City, CA
National Provider Identifier
1083930408
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48007 Issued in CA
Practice address
5620 Sawtelle Blvd
Culver City, CA 90230-5508
Phone
(310) 390-6212
NPI assigned
Apr 9, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48007 CA Primary

Addresses

Primary practice location

5620 Sawtelle Blvd
Culver City, CA 90230-5508

Mailing address

5620 Sawtelle Blvd
Culver City, CA 90230
Phone (310) 390-6212

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
I20190927000485 CA Practitioner - Oral Surgery 0143528505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48007CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Sabbagh-Fard DDS & P. Mastour DDS Inc Dentist CurrentSince Mar 1, 2020 Accepting new patients
Fard & Mastour Dental Group Dentist PastSince Mar 1, 2020 Accepting new patients
Mastour & Fard Dental Corp PastSince Mar 1, 2020 Accepting new patients

Locations

5620 Sawtelle Blvd
Culver City, CA 90230
Phone (310) 390-6212

Organizations & group practices 3

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1083930408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 SAWTELLE BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-390-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 SAWTELLE BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305508",
            "telephone_number": "310-390-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "S FARD",
        "first_name": "ARASH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-09",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.