NPIMap

Organization Active NPI

F. Moftakhar DDS a Professional Corp.

  • General Practice Dentistry
  • Fremont, CA
National Provider Identifier
1215054317
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38565 Issued in CA
Legal business name
F. MOFTAKHAR DDS A PROFESSIONAL CORP.
Doing business as
BROOKVALE FAMILY DENTAL
Practice address
39236 Argonaut Way
Fremont, CA 94538-1306
Phone
(510) 739-0701
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Farshad Moftakhar, D.D.S.
Title
Owner / Ceo
Phone
(626) 246-0150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 38565 CA Primary

Addresses

Primary practice location

39236 Argonaut Way
Fremont, CA 94538-1306

Mailing address

39236 Argonaut Way
Fremont, CA 94538-1306

Other names 1

  • BROOKVALE FAMILY DENTAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bay Area Dental Specialty Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1215054317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39236 ARGONAUT WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39236 ARGONAUT WAY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381306",
            "telephone_number": "510-739-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F. MOFTAKHAR DDS A PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "MOFTAKHAR",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "626-246-0150",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKVALE FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.