Active NPI
Negar Kohandarvish, DDS
- Dentist
- Camarillo, CA
National Provider Identifier
1265648034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47379
- Practice address
- 2177 Ventura Blvd
Camarillo, CA 93010-7934 - Phone
- (805) 388-1048
- Fax
- (805) 389-1698
- NPI assigned
- May 16, 2007
- Last updated
- Dec 5, 2013
- Sex
- Female
- 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 | 47379 | CA | Primary |
Addresses
Primary practice location
2177 Ventura Blvd
Camarillo, CA 93010-7934
Mailing address
2177 Ventura Blvd
Camarillo, CA 93010-7934
Phone (805) 388-1048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47379 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Negar Kohandarvish DDS,Inc. | Dentist | Past | Accepting new patients |
| Shawn Rabizadeh DDS2, a Professional Dental Corp. | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Palm Dental Care
- Dentist
- Camarillo, CA
- NPI 1538472311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386201600000",
"number": "1265648034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2177 VENTURA BLVD",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930107934",
"telephone_number": "805-388-1048",
"fax_number": "805-389-1698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2177 VENTURA BLVD",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930107934",
"telephone_number": "805-388-1048",
"fax_number": "805-389-1698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHANDARVISH",
"first_name": "NEGAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2013-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.