Active NPI
Maryam Bahadori, DDS
- Dentist
- Laguna Niguel, CA
National Provider Identifier
1275790164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53552
- Practice address
- 28188 Moulton Pkwy Apt 2326
Laguna Niguel, CA 92677-7523 - Phone
- (949) 389-0197
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 53552 | CA | |
| Dentist | 122300000X | 53552 | CA | Primary |
Addresses
Primary practice location
28188 Moulton Pkwy Apt 2326
Laguna Niguel, CA 92677-7523
Mailing address
28188 Moulton Pkwy Apt 2326
Laguna Niguel, CA 92677-7523
Phone (949) 389-0197
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53552 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609718400000",
"number": "1275790164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28188 MOULTON PKWY APT 2326",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926777523",
"telephone_number": "949-389-0197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28188 MOULTON PKWY APT 2326",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926777523",
"telephone_number": "949-389-0197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAHADORI",
"first_name": "MARYAM",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "53552",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53552",
"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 Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.