Active NPI
Nima Javan
- Dentist
- Compton, CA
National Provider Identifier
1164078242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 104408
- Practice address
- 821 W Rosecrans Ave Ste a
Compton, CA 90222-3821 - Phone
- (312) 274-4524
- NPI assigned
- Aug 14, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 104408 | CA | Primary |
Addresses
Primary practice location
821 W Rosecrans Ave Ste a
Compton, CA 90222-3821
Mailing address
24802 Acropolis Dr
Mission Viejo, CA 92691-4608
Phone (714) 414-2271
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
| License | State | Type | Specialty |
|---|---|---|---|
| 104408 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Javan Dental Corporation | Dentist | Current | Accepting new patients |
Locations
1532 San Bernardino Ave
Ste A1
Pomona, CA 91767
Phone (714) 414-2271
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.
-
- Dentist
- Pomona, CA
- NPI 1366175804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568678400000",
"number": "1164078242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24802 ACROPOLIS DR",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926914608",
"telephone_number": "714-414-2271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 W ROSECRANS AVE STE A",
"city": "COMPTON",
"state": "CA",
"postal_code": "902223821",
"telephone_number": "312-274-4524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAVAN",
"first_name": "NIMA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2019-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "104408",
"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 Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.