Individual provider Active NPI

Farrokh Bashiri, DDS

  • Periodontics
  • Concord, CA
National Provider Identifier
1164596334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
41157 Issued in CA
Practice address
2991 Treat Blvd Ste J
Concord, CA 94518-3604
Phone
(925) 689-8110
Fax
(925) 689-1220
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 41157 CA Primary

Addresses

Primary practice location

2991 Treat Blvd Ste J
Concord, CA 94518-3604

Mailing address

2991 Treat Blvd Ste J
Concord, CA 94518-3604
Phone (925) 689-8110

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
I20160523001652 CA Order and Referring Only - DentistPractitioner - Dentist 1355630807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164596334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2991 TREAT BLVD STE J",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945183604",
            "telephone_number": "925-689-8110",
            "fax_number": "925-689-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2991 TREAT BLVD STE J",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945183604",
            "telephone_number": "925-689-8110",
            "fax_number": "925-689-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIRI",
        "first_name": "FARROKH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "41157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.