Organization Active NPI

Mehran R. Lari, DDS, PLLC

  • Dental Clinic/Center
  • Tucson, AZ
National Provider Identifier
1093083602
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6100 Issued in AZ
Legal business name
MEHRAN R. LARI, DDS, PLLC
Practice address
15631 N Oracle Rd
Suite 187
Tucson, AZ 85739-8691
Phone
(520) 825-8112
Fax
(520) 825-2242
NPI assigned
Dec 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Authorized official

Name
Dr. Mehran Rastegar-Lari, DDS
Title
Owner
Phone
(520) 820-1319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6100 AZ Primary

Addresses

Primary practice location

15631 N Oracle Rd
Suite 187
Tucson, AZ 85739-8691

Mailing address

15631 N Oracle Rd
Suite 187
Tucson, AZ 85739-8691
Phone (520) 825-8112

Other identifiers 1

IdentifierTypeStateIssuer
144939MedicaidAZ

Other names 1

  • Creative Smiles Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1093083602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15631 N ORACLE RD",
            "address_2": "SUITE 187",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857398691",
            "telephone_number": "520-825-8112",
            "fax_number": "520-825-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15631 N ORACLE RD",
            "address_2": "SUITE 187",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857398691",
            "telephone_number": "520-825-8112",
            "fax_number": "520-825-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHRAN R. LARI, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "RASTEGAR-LARI",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-820-1319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "6100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144939",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.