Individual provider Active NPI

Dorit Rafizadeh, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1306962824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41985 Issued in CA
Practice address
10913 Venice Blvd
Los Angeles, CA 90034
Phone
(310) 558-8123
Fax
(310) 558-8129
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41985 CA Primary

Addresses

Primary practice location

10913 Venice Blvd
Los Angeles, CA 90034

Mailing address

1944 Glendon Ave
#202
Los Angeles, CA 90025
Phone (310) 922-7304

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160219000968 CA Order and Referring Only - DentistPractitioner - DentistPractitioner - General Practice 6901101534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
K Muhammad Tajsar DDS Ink Past 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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306962824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 GLENDON AVE",
            "address_2": "#202",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-922-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10913 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90034",
            "telephone_number": "310-558-8123",
            "fax_number": "310-558-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFIZADEH",
        "first_name": "DORIT",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.