Omeed Mahboobian, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103828 Issued in CA

Practice address

1217 Wilshire Blvd
Suite 3043
Santa Monica, CA 90403

Phone

(424) 261-5115

NPI assigned

Jul 1, 2019

Last updated

Mar 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Abner Mahboobian Dental Corporation

  • Dental Clinic/Center
  • South Gate, CA
  • NPI 1265221105
  NPD Authorized official
• Abner Mahboobian Dental Partnership

  dba Ultra Dental

  • General Practice Dentistry
  • San Fernando, CA
  • NPI 1427700947
  NPD Authorized official
• Omeed Mahboobian DDS, Inc

  • General Practice Dentistry
  • San Fernando, CA
  • NPI 1366189300
  NPD Authorized official

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1255993069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 26TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032201",
            "telephone_number": "310-435-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 WILSHIRE BLVD",
            "address_2": "SUITE 3043",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "424-261-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHBOOBIAN",
        "first_name": "OMEED",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marguerite Maguire, M.D.
• Roger J. Mah, M.D.
• Walcharee Cindy Mahamitra, D.O.
• Michelle Mahanian Oheb, M.D.
• Mahasty Mahooty Rdhap Healthy Smiles of California Dental Hygiene, Inc
• Mehrnaz Mahdad, PT
• Cory D. Mahler, M.D.
• Larissa Ann Maichrowicz, PT, DPT
• Anna Maier
• Aleksandr Mailyan, LMT

• General Practice Dentistry in Santa Monica, CA
• Providers in Santa Monica, 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 Mar 16, 2022; 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.