Active NPI
Payam Mojab, D.D.S.
- Dentist
- Huntington Park, CA
National Provider Identifier
1265756027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38334
- Practice address
- 2542 E Florence Ave
#A
Huntington Park, CA 90255-4780 - Phone
- (323) 582-0755
- Fax
- (323) 582-7392
- NPI assigned
- Mar 23, 2010
- Sex
- Male
- 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 | 38334 | CA | Primary |
Addresses
Primary practice location
2542 E Florence Ave
#A
Huntington Park, CA 90255-4780
Mailing address
2542 E Florence Ave
#A
Huntington Park, CA 90255-4780
Phone (323) 582-0755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G93942-01 | Other | CA | DENTICAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38334 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Payam Mojab DDS Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1265756027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2542 E FLORENCE AVE",
"address_2": "#A",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902554780",
"telephone_number": "323-582-0755",
"fax_number": "323-582-7392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2542 E FLORENCE AVE",
"address_2": "#A",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902554780",
"telephone_number": "323-582-0755",
"fax_number": "323-582-7392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOJAB",
"first_name": "PAYAM",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-23",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "38334",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "G93942-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.