Organization Active NPI

Shahrokh Jedian DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1275779795
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SHAHROKH JEDIAN DDS
Practice address
998 S Robertson Blvd
Los Angeles, CA 90035-1637
Phone
(310) 358-1200
NPI assigned
Jan 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Shahrokh Jedian
Title
President
Phone
(310) 404-6476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

998 S Robertson Blvd
Los Angeles, CA 90035-1637

Mailing address

998 S Robertson Blvd
Los Angeles, CA 90035-1637

Other identifiers 1

IdentifierTypeStateIssuer
1407052814OtherCANPI

National Provider Directory

National Provider Directory

Locations

998 S Robertson Blvd
Los Angeles, CA 90035
Phone (310) 358-1200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1275779795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351637",
            "telephone_number": "310-358-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHROKH JEDIAN DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "JEDIAN",
        "authorized_official_first_name": "SHAHROKH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-404-6476"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407052814",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; 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.