Individual provider Active NPI

Mohsen Haghighatpour, DDS MD

  • Dentist
  • Hawthorne, CA
National Provider Identifier
1275680712
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49327 Issued in CA
Practice address
13624 Hawthorne Blvd
Suite 205 Sunrise Dental Group
Hawthorne, CA 90250
Phone
(310) 856-6574
Fax
(310) 856-6578
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49327 CA Primary

Addresses

Primary practice location

13624 Hawthorne Blvd
Suite 205 Sunrise Dental Group
Hawthorne, CA 90250

Mailing address

13624 Hawthorne Blvd
Suite 205
Hawthorne, CA 90250
Phone (310) 856-6574

Other identifiers 1

IdentifierTypeStateIssuer
G9289701MedicaidCA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
49327CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275680712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13624 HAWTHORNE BLVD",
            "address_2": "SUITE 205",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-856-6574",
            "fax_number": "310-856-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13624 HAWTHORNE BLVD",
            "address_2": "SUITE 205 SUNRISE DENTAL GROUP",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "310-856-6574",
            "fax_number": "310-856-6578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGHIGHATPOUR",
        "first_name": "MOHSEN",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9289701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.