Individual provider Active NPI

Keivan Sarraf, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
National Provider Identifier
1154410256
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
52466 Issued in CA
Practice address
5703 S Vermont Ave
Los Angeles, CA 90037-3930
Phone
(323) 751-5600
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 52466 CA Primary

Addresses

Primary practice location

5703 S Vermont Ave
Los Angeles, CA 90037-3930

Mailing address

5703 S Vermont Ave
Los Angeles, CA 90037-3930
Phone (323) 751-5600

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
52466CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Keivan Sarraf, DDS, Inc Past Accepting new patients

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1154410256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5703 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373930",
            "telephone_number": "323-751-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5703 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373930",
            "telephone_number": "323-751-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRAF",
        "first_name": "KEIVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "52466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.