Active NPI
Ike Himayat Rahimi, DMD
- Dentist
- Placerville, CA
National Provider Identifier
1174525331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 52455
- Practice address
- 1045 Marshall Way
Placerville, CA 95667-5721 - Phone
- (530) 622-0701
- Fax
- (530) 622-7695
- NPI assigned
- Jun 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | 52455 | CA | Primary |
Addresses
Primary practice location
1045 Marshall Way
Placerville, CA 95667-5721
Mailing address
2808 Mallord LN
Placerville, CA 95667
Phone (530) 622-0701
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 |
|---|---|---|---|
| 52455 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1174525331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2808 MALLORD LN",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "95667",
"telephone_number": "530-622-0701",
"fax_number": "530-663-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 MARSHALL WAY",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956675721",
"telephone_number": "530-622-0701",
"fax_number": "530-622-7695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHIMI",
"first_name": "IKE",
"middle_name": "HIMAYAT",
"name_prefix": "Mr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "52455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.