Active NPI
Behzad Fadaei, D.D.S
- Dentist
- Van Nuys, CA
National Provider Identifier
1285066548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62751
- Practice address
- 6265 Sepulveda Blvd #14
Van Nuys, CA 91411 - Phone
- (818) 787-6787
- Fax
- (818) 922-2525
- NPI assigned
- Aug 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62751 | CA | Primary |
Addresses
Primary practice location
6265 Sepulveda Blvd #14
Van Nuys, CA 91411
Mailing address
6265 Sepulveda Blvd #14
Van Nuys, CA 91411
Phone (818) 983-4021
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
| License | State | Type | Specialty |
|---|---|---|---|
| 62751 | CA | MD | Pharmacist |
Interoperability endpoints
- bfadaei@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1285066548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6265 SEPULVEDA BLVD #14",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "91411",
"telephone_number": "818-983-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6265 SEPULVEDA BLVD #14",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "91411",
"telephone_number": "818-787-6787",
"fax_number": "818-922-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADAEI",
"first_name": "BEHZAD",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-08",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.