Individual provider Active NPI

Elena Shabani, D.D.S

  • Dentist
  • Glendale, CA
National Provider Identifier
1306216544
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
65135 Issued in CA
Practice address
914 N Louise St Apt 7
Glendale, CA 91207-2175
Phone
(818) 426-8607
NPI assigned
Sep 30, 2015
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65135 CA Primary

Addresses

Primary practice location

914 N Louise St Apt 7
Glendale, CA 91207-2175

Mailing address

914 N. Louise St #7
Glendale, CA 91207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710003329 CA Practitioner - Dentist 8123352986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65135CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elena Shabani DDS Inc CurrentSince Feb 6, 2017 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1306216544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N. LOUISE ST #7",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N LOUISE ST APT 7",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072175",
            "telephone_number": "818-426-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABANI",
        "first_name": "ELENA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.