NPIMap

Organization Active NPI

Shahram Hosseini DDS, Inc.

Doing business as New Age Family Dental Group

  • Exclusive Provider Organization
  • Woodland Hills, CA
National Provider Identifier
1205106242
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
53068 Issued in CA
Legal business name
SHAHRAM HOSSEINI DDS, INC.
Doing business as
New Age Family Dental Group
Practice address
23111 Ventura Blvd
Suite #204
Woodland Hills, CA 91364-1103
Phone
(818) 225-1630
NPI assigned
Jan 9, 2012
Last updated
Jan 9, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
SHAHRAM HOSSEINI DDS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Shahram Hosseini, DDS
Title
Dentist
Phone
(818) 225-1630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 53068 CA Primary

Addresses

Primary practice location

23111 Ventura Blvd
Suite #204
Woodland Hills, CA 91364-1103

Mailing address

23111 Ventura Blvd
Suite #204
Woodland Hills, CA 91364
Phone (818) 225-1630

Other names 1

  • New Age Family Dental Group Doing business as

National Provider Directory

National Provider Directory
Part of
Shahram Hosseini DDS Inc

Locations

1240 S Westlake Blvd
Westlake Village, CA 91361
Phone (805) 495-7212

23111 Ventura Blvd
Ste 204
Woodland Hls, CA 91364
Phone (818) 225-1630

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1205106242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD",
            "address_2": "SUITE #204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91364",
            "telephone_number": "818-225-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD",
            "address_2": "SUITE #204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641103",
            "telephone_number": "818-225-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRAM HOSSEINI DDS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAHRAM HOSSEINI DDS, INC.",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "HOSSEINI",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-225-1630",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "53068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Age Family Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.