Active NPI
Jasmine Elmira Douraghi, DMD
- Dentist
- Riverside, CA
National Provider Identifier
1255117958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS109244
- Practice address
- 8715 Trautwein Rd Ste a
Riverside, CA 92508-9474 - Phone
- (951) 776-1330
- NPI assigned
- Sep 7, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS109244 | CA | Primary |
Addresses
Primary practice location
8715 Trautwein Rd Ste a
Riverside, CA 92508-9474
Mailing address
6280 E Palo Alto Dr
Anaheim, CA 92807-4011
Phone (714) 363-6304
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240131003846 | CA | Order and Referring Only - Dentist | 6204289788 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS109244 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1255117958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6280 E PALO ALTO DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074011",
"telephone_number": "714-363-6304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8715 TRAUTWEIN RD STE A",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925089474",
"telephone_number": "951-776-1330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOURAGHI",
"first_name": "JASMINE",
"middle_name": "ELMIRA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS109244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.