Individual provider Active NPI

Raffi Asadorian, DDS

  • Dentist
  • Ventura, CA
National Provider Identifier
1144587064
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103063 Issued in CA
Practice address
1001 Partridge Dr Ste 210
Ventura, CA 93003-0716
Phone
(805) 644-9501
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103063 CA Primary

Addresses

Primary practice location

1001 Partridge Dr Ste 210
Ventura, CA 93003-0716

Mailing address

1001 Partridge Dr Ste 210
Ventura, CA 93003-0716
Phone (805) 644-9501

Other practice location 1

780 E Centerville Rd Ste 100
Garland, TX 75041-4640
Phone (214) 429-3650

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
I20240125001663 CA Practitioner - Dentist 6002269156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103063CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Nov 26, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Nov 26, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist Current Accepting new patients

Locations

10501 Lakewood Blvd
Downey, CA 90241
Phone (562) 862-2341

10501 Lakewood Blvd
#B
Downey, CA 90241
Phone (562) 862-2341

4167 Ohio St
San Diego, CA 92104
Phone (619) 281-6635

5168 Hollister Ave
Santa Barbara, CA 93111
Phone (805) 683-5300

3355 Cochran St
Ste 206
Simi Valley, CA 93063
Phone (805) 520-1100

41593 Winchester Rd
Ste 211
Temecula, CA 92590
Phone (562) 862-2341

Organizations & group practices 3

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1144587064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PARTRIDGE DR STE 210",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030716",
            "telephone_number": "805-644-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PARTRIDGE DR STE 210",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030716",
            "telephone_number": "805-644-9501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 E Centerville Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750414640",
            "country_code": "US",
            "telephone_number": "214-429-3650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASADORIAN",
        "first_name": "RAFFI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.