Individual provider Active NPI

Reza Abbasian, DDS

  • General Practice Dentistry
  • Buena Park, CA
National Provider Identifier
1124802673
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109154 Issued in CA
Practice address
8381 La Palma Ave Ste a-B
Buena Park, CA 90620-3271
Phone
(714) 228-9990
NPI assigned
Aug 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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 109154 CA Primary

Addresses

Primary practice location

8381 La Palma Ave Ste a-B
Buena Park, CA 90620-3271

Mailing address

422 Fountainhead
Irvine, CA 92618-0805
Phone (949) 524-9911

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
109154CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1124802673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 FOUNTAINHEAD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180805",
            "telephone_number": "949-524-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8381 LA PALMA AVE STE A-B",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203271",
            "telephone_number": "714-228-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASIAN",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.