Active NPI
Mahin Rezamand, RDA
- Dental Assistant
- Montebello, CA
National Provider Identifier
1164914487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 1451 N Montebello Blvd
Montebello, CA 90640-2584 - Phone
- (323) 724-9955
- NPI assigned
- Jun 1, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
1451 N Montebello Blvd
Montebello, CA 90640-2584
Mailing address
3733 White Ash Rd
San Bernardino, CA 92407-9008
Phone (626) 485-7714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NCF780A52374 | Other | ANTHEM BLUE CROSS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527811200000",
"number": "1164914487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3733 WHITE ASH RD",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924079008",
"telephone_number": "626-485-7714",
"fax_number": "909-571-5850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1451 N MONTEBELLO BLVD",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906402584",
"telephone_number": "323-724-9955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZAMAND",
"first_name": "MAHIN",
"name_prefix": "Mrs.",
"credential": "RDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-01",
"last_updated": "2018-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "NCF780A52374",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Montebello, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.