Individual provider Active NPI

Farrokh Kolahi Aval

  • General Practice Dentistry
  • Laguna Niguel, CA
National Provider Identifier
1275366288
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110616 Issued in CA
Practice address
32 Amarante
Laguna Niguel, CA 92677-8929
Phone
(818) 458-5820
NPI assigned
Aug 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 110616 CA Primary

Addresses

Primary practice location

32 Amarante
Laguna Niguel, CA 92677-8929

Mailing address

32 Amarante
Laguna Niguel, CA 92677-8929
Phone (818) 458-5820

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

LicenseStateTypeSpecialty
110616CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1275366288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 AMARANTE",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926778929",
            "telephone_number": "818-458-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 AMARANTE",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926778929",
            "telephone_number": "818-458-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLAHI AVAL",
        "first_name": "FARROKH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.