Active NPI
Mehran R. Lari, DDS, PLLC
- Dental Clinic/Center
- Tucson, AZ
National Provider Identifier
1093083602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- 6100
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144939 | Medicaid | AZ |
Other names 1
- Creative Smiles
National Provider Directory
National Provider DirectoryNPI 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.