Individual provider Active NPI

Akbar Heidarinia, D.M.D.

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1104804780
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37117 Issued in CA
Practice address
235 S Tustin St
Orange, CA 92866-2321
Phone
(949) 874-3366
Fax
(714) 744-0024
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 37117 CA Primary

Addresses

Primary practice location

235 S Tustin St
Orange, CA 92866-2321

Mailing address

1 Scotia Sea
Newport Coast, CA 92657-2104
Phone (949) 715-3132

Other practice location 1

980 N Tustin St
Orange, CA 92867-5903
Phone (714) 997-1005

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

State licenses

LicenseStateTypeSpecialty
37117CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Akbar Heidarinia DMD Inc Past Accepting new patients
Akbar Heidarinia DMD Inc General Practice Past Accepting new patients
Akbar Heidarinia DMD Inc General Practice PastSince Dec 16, 2020 Accepting new patients
Petri Dental Corporation General Practice PastSince Dec 16, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1104804780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SCOTIA SEA",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926572104",
            "telephone_number": "949-715-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S TUSTIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662321",
            "telephone_number": "949-874-3366",
            "fax_number": "714-744-0024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "980 N Tustin St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928675903",
            "country_code": "US",
            "telephone_number": "714-997-1005",
            "fax_number": "714-997-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDARINIA",
        "first_name": "AKBAR",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2020; 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.