Active NPI
Parviz Rahimzadeh, DDS
- Dentist
- Culver City, CA
National Provider Identifier
1255515102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55923
- Practice address
- 6035 Bristol Pkwy
Suite 200
Culver City, CA 90230-6601 - Phone
- (800) 373-5400
- NPI assigned
- Dec 27, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 55923 | CA | Primary |
Addresses
Primary practice location
6035 Bristol Pkwy
Suite 200
Culver City, CA 90230-6601
Mailing address
6035 Bristol Pkwy
Suite 200
Culver City, CA 90230-6601
Phone (800) 373-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55923 | Medicaid | CA |
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 |
|---|---|---|---|---|
| I20151012000692 | CA | Order and Referring Only - Dentist | 7810206927 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55923 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alex Gladkov, DDS | Dentist | Past | Accepting new patients |
| Lumina Healthcare, LLC | Past | Accepting new patients |
Interoperability endpoints
- prahimzadeh@direct.westerndental.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1932343589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1255515102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 BRISTOL PKWY",
"address_2": "SUITE 200",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306601",
"telephone_number": "800-373-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 BRISTOL PKWY",
"address_2": "SUITE 200",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306601",
"telephone_number": "800-373-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHIMZADEH",
"first_name": "PARVIZ",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-27",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55923",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.