Ninus Ebrahimi, DMD, a Dental Corporation

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

NINUS EBRAHIMI, DMD, A DENTAL CORPORATION

Doing business as

North Star Pediatric Dentistry

Practice address

1240 S Westlake Blvd Ste 127
Westlake Village, CA 91361-1984

Phone

(805) 409-9195

NPI assigned

Aug 9, 2022

Last updated

Aug 9, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ninus Ebrahimi, DMDNPI 1063760965

Title

Owner

Phone

(805) 409-9195

Specialties & licenses 1

Addresses

Other names 1

• North Star Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ninus Ebrahimi, D.M.D.

  • Pediatric Dentistry
  • Westlake Village, CA
  • NPI 1063760965
  NPD Authorized official

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1275261257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD STE 127",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611984",
            "telephone_number": "805-409-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S WESTLAKE BLVD STE 127",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913611984",
            "telephone_number": "805-409-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINUS EBRAHIMI, DMD, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI",
        "authorized_official_first_name": "NINUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-409-9195",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Star Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Sanada Physical Therapy, PC
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• Ninus Ebrahimi, DMD, a Dental Corporation (North Star Pediatric Dentistry)
• Grant Nishimura, DDS, MD
• Russell Dean Nishimura, D.D.S.
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• Pediatric Dentistry in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.