Individual provider Active NPI

Roshanak Haghshenas, DDS

  • Dentist
  • Anaheim, CA
National Provider Identifier
1295947760
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103446 Issued in CA
Practice address
1007 W la Palma Ave, Suite 2
Anaheim, CA 92801-3620
Phone
(714) 490-1231
Fax
(714) 490-0715
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22418 TX
Dentist 122300000X 103446 CA Primary

Addresses

Primary practice location

1007 W la Palma Ave, Suite 2
Anaheim, CA 92801-3620

Mailing address

1007 W la Palma Ave, Suite 2
Anaheim, CA 92801-3620
Phone (424) 429-9107

Other practice location 1

11900 Bellaire Blvd
Houston, TX 77072-2304
Phone (281) 564-6665

Other identifiers 2

IdentifierTypeStateIssuer
175689202MedicaidTX
175689203MedicaidTX

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

LicenseStateTypeSpecialty
103446CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Roshanak Haghshenas DDS Inc PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1295947760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 W LA PALMA AVE, SUITE 2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013620",
            "telephone_number": "424-429-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W LA PALMA AVE, SUITE 2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928013620",
            "telephone_number": "714-490-1231",
            "fax_number": "714-490-0715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11900 Bellaire Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770722304",
            "country_code": "US",
            "telephone_number": "281-564-6665",
            "fax_number": "281-561-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGHSHENAS",
        "first_name": "ROSHANAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-06-23",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22418",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175689202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175689203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.