Reza Mohammad Ghahremani
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Northdridge, CA
NPI 1295901015 · NPPES record last updated May 28, 2025
Key facts
- NPI
- 1295901015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 34492 (CA)
- Practice address
- 8540 Reseda Blvd. #102
Northdridge, CA 91324-6144 - Phone
- (818) 280-0385
- Fax
- (818) 701-0418
- NPI assigned
- May 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34492 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garemani Shahmohammadi DDS Professional Dental Corp | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 34492 | CA | Yes |
Addresses
Primary practice location
8540 Reseda Blvd. #102
Northdridge, CA 91324-6144
Mailing address
8540 Reseda Blvd. #102
Northdridge, CA 91324
Phone (818) 280-0385
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.