Individual provider Active NPI

Maral Ranjbar Aghdam

  • Dentist
  • Compton, CA
National Provider Identifier
1144713173
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
102522 Issued in CA
Practice address
1821 N Long Beach Blvd
Compton, CA 90221
Phone
(714) 262-2708
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 102522 CA Primary

Addresses

Primary practice location

1821 N Long Beach Blvd
Compton, CA 90221

Mailing address

3205-1151 West Georgia St
Vancouver, BRITISH COLUMBIA V6E4E6
CA

Other practice location 1

4487 Slauson Ave
Maywood, CA 90270-2943
Phone (714) 262-2708

Other practice location 2

3561 W Century Blvd
Inglewood, CA 90303-1223
Phone (714) 262-2708

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
102522CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Maral Ranjbar, a Professional Dental Corporation CurrentSince Apr 9, 2024 Accepting new patients

Locations

3878 W Carson St
Ste 200
Torrance, CA 90503
Phone (310) 316-6062

Organizations & group practices 1

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1144713173",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "3205-1151 WEST GEORGIA ST",
            "city": "VANCOUVER",
            "state": "BRITISH COLUMBIA",
            "postal_code": "V6E4E6"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 N LONG BEACH BLVD",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "90221",
            "telephone_number": "714-262-2708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4487 Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "CA",
            "postal_code": "902702943",
            "country_code": "US",
            "telephone_number": "714-262-2708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3561 W Century Blvd",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903031223",
            "country_code": "US",
            "telephone_number": "714-262-2708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANJBAR AGHDAM",
        "first_name": "MARAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.