Abolghassem Madani, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25327 Issued in CA

Practice address

20932 Brookhurst St
Ste 207
Huntington Beach, CA 92646-6638

Phone

(714) 965-9870

Fax

(714) 965-9870

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205907417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20932 BROOKHURST ST",
            "address_2": "STE 207",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926466638",
            "telephone_number": "714-965-9870",
            "fax_number": "714-965-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20932 BROOKHURST ST",
            "address_2": "STE 207",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926466638",
            "telephone_number": "714-965-9870",
            "fax_number": "714-965-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADANI",
        "first_name": "ABOLGHASSEM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanita Mack, DPT
• Kristin Mackay
• Cleve S Mackenzie, MD
• Jorrie Stuart Mackenzie, PH.D.
• Robert M Mackie, DMD
• Gavin Maddox, MASSAGE THERAPIST
• Gilbert Diallo Madison, SUDCC III-CS
• Diana Madokoro, PHARM.D
• Madrigal Psychological Services
• Mary Grace Madrigal, PHD

• General Practice Dentistry in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.