Individual provider Active NPI

Fereshteh Yousefzadeh, DDS, MSD, INC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Los Angeles, CA
National Provider Identifier
1205019072
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
53961 Issued in CA
Practice address
10884 Santa Monica Blvd. #401
Los Angeles, CA 90025
Phone
(310) 750-4621
NPI assigned
Dec 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 53961 CA Primary

Addresses

Primary practice location

10884 Santa Monica Blvd. #401
Los Angeles, CA 90025

Mailing address

22287 Moulhollan Highway
#145
Calabasas, CA 91302
Phone (310) 750-7621

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fereshteh Yousefzadeh, DDS, MSD, Inc Orthodontics and Dentofacial Orthopedics CurrentSince Dec 17, 2023 Accepting new patients

Locations

10884 Santa Monica Blvd
Ste 401
Los Angeles, CA 90025
Phone (310) 446-4410

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.

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1205019072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22287 MOULHOLLAN HIGHWAY",
            "address_2": "#145",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "91302",
            "telephone_number": "310-750-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10884 SANTA MONICA BLVD. #401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-750-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFZADEH",
        "first_name": "FERESHTEH",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD, INC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "53961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.