Paul Mirdamadi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D011746 Issued in AZ

Practice address

511 Encinitas Blvd Ste 118-120
Encinitas, CA 92024-3775

Phone

(213) 259-4867

NPI assigned

Jul 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Parham Mirdamadi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1174000574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 ENCINITAS BLVD STE 118-120",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243775",
            "telephone_number": "213-259-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 ENCINITAS BLVD STE 118-120",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243775",
            "telephone_number": "213-259-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRDAMADI",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D011746",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS104753",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PARHAM",
            "last_name": "MIRDAMADI",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard J Miller, PT
• Aaron Mills, L.AC.
• Morgan Jillian Milmore, ASW
• Susan W Minas, LCSW
• Arezou Minooee, M.D.
• Kathryn Mirth, PA
• Adnan Mirza, MD
• Victoria M. Mirza, M.D.
• Ara Mirzaian, CO
• Majel Josephine Miskinis, RCP

• Oral and Maxillofacial Surgery (Dentist) in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.