Mehdi Moradiseresht

Primary specialty

DentistTaxonomy code 122300000X

License

DDS103148 Issued in CA

Practice address

19749 Ventura Blvd
Woodland Hills, CA 91364-2623

Phone

(818) 661-4680

NPI assigned

Nov 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mehdi Moradiseresht DDS, Inc

  • General Practice Dentistry
  • Woodland Hills, CA
  • NPI 1043932585
  NPD Authorized official
• Mehdi Moradiseresht, D.D.S., Inc.

  dba Canoga Park Family Dentistry

  • General Practice Dentistry
  • Canoga Park, CA
  • NPI 1477363463
  NPD Authorized official
• H. Abdolhosseini, D.D.S., Inc

  • Dentist
  • Fullerton, CA
  • NPI 1801154851
  NPD (past)

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1093283855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914080538",
            "telephone_number": "310-985-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19749 VENTURA BLVD",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642623",
            "telephone_number": "818-661-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORADISERESHT",
        "first_name": "MEHDI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-08",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lankavi Guneratne Moore, LMFT
• Yasmine Moorman
• Amanda Danielle Mora
• Risa Breeze Morabe
• Kourosh Moradi, MD
• Virginia Morales Sanchez
• Alicia Morales, BS
• Angel Morales
• Cassandra Morales
• Damaris Morales

• Dentist in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.