Active NPI
Marjan Kazemi
- Dentist
- Yorba Linda, CA
National Provider Identifier
1174174882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 104418
- Practice address
- 20350 Longbay Dr
Yorba Linda, CA 92887-3247 - Phone
- (720) 447-0068
- NPI assigned
- Sep 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS104418 | CA | |
| Dentist | 122300000X | 104418 | CA | Primary |
Addresses
Primary practice location
20350 Longbay Dr
Yorba Linda, CA 92887-3247
Mailing address
20350 Longbay Dr
Yorba Linda, CA 92887-3247
Phone (720) 447-0068
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 |
|---|---|---|---|
| 104418 | CA | MD | Dentist |
| DDS104418 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1174174882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20350 LONGBAY DR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928873247",
"telephone_number": "720-447-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20350 LONGBAY DR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928873247",
"telephone_number": "720-447-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZEMI",
"first_name": "MARJAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-24",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS104418",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "104418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.