Active NPI
Irvin Richard Massoth, DDS, MSD
- Endodontics
- Tarzana, CA
National Provider Identifier
1194803650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 28957
- Practice address
- 5567 Reseda Blvd
#100
Tarzana, CA 91356-2674 - Phone
- (818) 705-1274
- Fax
- (818) 705-6782
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 28957 | CA | Primary |
Addresses
Primary practice location
5567 Reseda Blvd
#100
Tarzana, CA 91356-2674
Mailing address
5567 Reseda Blvd
#100
Tarzana, CA 91356-2674
Phone (818) 705-1274
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 709866 | Other | CA | UNITED CONCORDIA-TAX ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28957 | CA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I.Richard Massoth, DDS, Lise Laflamme, DMD | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- Tarzana, CA
- NPI 1972817427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194803650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5567 RESEDA BLVD",
"address_2": "#100",
"city": "TARZANA",
"state": "CA",
"postal_code": "913562674",
"telephone_number": "818-705-1274",
"fax_number": "818-705-6782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5567 RESEDA BLVD",
"address_2": "#100",
"city": "TARZANA",
"state": "CA",
"postal_code": "913562674",
"telephone_number": "818-705-1274",
"fax_number": "818-705-6782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSOTH",
"first_name": "IRVIN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "28957",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA-TAX ID",
"identifier": "709866",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.