Individual provider Active NPI

Shahrouz Zarrabi, M.D., D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Corona del Mar, CA
National Provider Identifier
1114153509
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
101197 Issued in CA
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180227001050 CA Order and Referring Only - DentistPractitioner - Dentist 4688935042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A146795CAMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Zarrabi MD, Facial Cosmetic and Maxillo-Facial Surgery CurrentSince Aug 23, 2020 Accepting new patients
Zarrabi Surgery Center, Inc CurrentSince Oct 19, 2020 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.

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

Verify at the official NPI Registry.