Mohammud Reza Razi Hamedani, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107136 Issued in CA

Practice address

14401 Burbank Blvd
Van Nuys, CA 91401-4824

Phone

(310) 746-7690

NPI assigned

Nov 25, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637798400000",
    "number": "1215694161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10562 EASTBORNE AVE APT 1/2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246084",
            "telephone_number": "310-746-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 BURBANK BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914014824",
            "telephone_number": "310-746-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMEDANI",
        "first_name": "MOHAMMUD REZA",
        "middle_name": "RAZI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-25",
        "last_updated": "2021-11-25",
        "certification_date": "2021-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Ham
• Jonathan Hamada
• Anna Hambardzumyan
• Hamburger Home
• Madena Hamed
• Ahmadali Hamidi, MD
• Elizabeth Hamilton
• Kevin D Hammer
• Lloyd M Hamner, LMFT
• Jee Yeon Han

• General Practice Dentistry in Van Nuys, CA
• Providers in Van Nuys, 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 Nov 25, 2021; 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.