Active NPI
Shahrouz Zarrabi, M.D., D.D.S.
- Oral & Maxillofacial Surgery (D.M.D.)
- Corona del Mar, CA
National Provider Identifier
1114153509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- 101197
- Practice address
- 2865 E Coast Hwy Ste 300
Corona del Mar, CA 92625-2258 - Phone
- (917) 327-9969
- NPI assigned
- May 31, 2009
- Last updated
- Dec 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NU | ||
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | A146795 | CA | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 101197 | CA | Primary |
Addresses
Primary practice location
2865 E Coast Hwy Ste 300
Corona del Mar, CA 92625-2258
Mailing address
2865 E Coast Hwy Ste 300
Corona del Mar, CA 92625-2258
Phone (949) 873-0807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180227001050 | CA | Order and Referring Only - Dentist | 4688935042 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A146795 | CA | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zarrabi MD, Facial Cosmetic and Maxillo-Facial Surgery | Current | Accepting new patients | |
| Zarrabi Surgery Center, Inc | Current | Accepting new patients |
Locations
2865 E Coast Hwy
Ste 300
Corona del Mar, CA 92625
Phone (917) 327-9969
Organizations & group practices 2
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.
-
- Ambulatory Surgical Clinic/Center
- Corona del Mar, CA
- NPI 1326659335
-
- Ambulatory Surgical Clinic/Center
- Corona del Mar, CA
- NPI 1922606425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1114153509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2865 E COAST HWY STE 300",
"city": "CORONA DEL MAR",
"state": "CA",
"postal_code": "926252258",
"telephone_number": "949-873-0807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 E COAST HWY STE 300",
"city": "CORONA DEL MAR",
"state": "CA",
"postal_code": "926252258",
"telephone_number": "917-327-9969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZARRABI",
"first_name": "SHAHROUZ",
"name_prefix": "Dr.",
"credential": "M.D., D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-31",
"last_updated": "2022-12-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "CA",
"license": "A146795",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "CA",
"license": "101197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corona del Mar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.