Active NPI
Pegah Pourrahimi, D.D.S.
- Dentist
- Thousand Oaks, CA
National Provider Identifier
1184994717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 58614
- Practice address
- 555 Marin St
Suite 150
Thousand Oaks, CA 91360-4236 - Phone
- (805) 405-4692
- NPI assigned
- Jan 12, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58614 | CA | Primary |
Addresses
Primary practice location
555 Marin St
Suite 150
Thousand Oaks, CA 91360-4236
Mailing address
555 Marin St
Suite 150
Thousand Oaks, CA 91360-4236
Phone (805) 405-4692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 8, 2016 through Mar 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58614 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395964800000",
"number": "1184994717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 MARIN ST",
"address_2": "SUITE 150",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604236",
"telephone_number": "805-405-4692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 MARIN ST",
"address_2": "SUITE 150",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604236",
"telephone_number": "805-405-4692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POURRAHIMI",
"first_name": "PEGAH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-12",
"last_updated": "2014-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.