Active NPI
Mahshid Fahandeza, DMD
- Dentist
- El Centro, CA
National Provider Identifier
1093995482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56288
- Practice address
- 646 W Main Street
Suite a
El Centro, CA 92243 - Phone
- (760) 339-9992
- Fax
- (760) 353-3635
- NPI assigned
- Nov 14, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 56288 | CA | Primary |
Addresses
Primary practice location
646 W Main Street
Suite a
El Centro, CA 92243
Mailing address
646 W Main Street
Suite a
El Centro, CA 92243
Phone (760) 339-9992
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1093995482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "646 W MAIN STREET",
"address_2": "SUITE A",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "92243",
"telephone_number": "760-339-9992",
"fax_number": "760-353-3635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "646 W MAIN STREET",
"address_2": "SUITE A",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "92243",
"telephone_number": "760-339-9992",
"fax_number": "760-353-3635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHANDEZA",
"first_name": "MAHSHID",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-14",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Centro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.