Individual provider Active NPI

Soheil Refoua

  • Dentist
  • South Gate, CA
National Provider Identifier
1205651106
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS110420 Issued in CA
Practice address
8627 Atlantic Ave
South Gate, CA 90280-3501
Phone
(888) 499-9303
NPI assigned
Nov 18, 2024
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS110420 CA Primary

Addresses

Primary practice location

8627 Atlantic Ave
South Gate, CA 90280-3501

Mailing address

2118 Malcolm Ave
Los Angeles, CA 90025-6306
Phone (310) 746-7959

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

LicenseStateTypeSpecialty
DDS110420CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
West Los Angeles Dentistry PastSince Nov 1, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1205651106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 MALCOLM AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256306",
            "telephone_number": "310-746-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8627 ATLANTIC AVE",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803501",
            "telephone_number": "888-499-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REFOUA",
        "first_name": "SOHEIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS110420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.