Payam Behradnia Dmo, a Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

60893 Issued in CA

Legal business name

PAYAM BEHRADNIA DMO, A DENTAL CORP

Practice address

4757 Hoen Ave
Santa Rosa, CA 95405-7862

Phone

(707) 575-9595

Fax

(707) 575-5122

NPI assigned

Mar 31, 2015

Last updated

Mar 31, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Payam Behradnia, DENTISTNPI 1194038059

Title

Ceo

Phone

(707) 575-9595

Specialties & licenses 1

Addresses

Tax ID family

Ez Smile Family Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ez Smile Family Dental Group

  • Health Maintenance Organization
  • Santa Rosa, CA
  • NPI 1669846416
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Payam Behradnia, DDS

  • Dentist
  • Santa Rosa, CA
  • NPI 1194038059
  Authorized official Same address or phone

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1316332000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4757 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057862",
            "telephone_number": "707-575-9595",
            "fax_number": "707-575-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057862",
            "telephone_number": "707-575-9595",
            "fax_number": "707-575-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYAM BEHRADNIA DMO, A DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "BEHRADNIA",
        "authorized_official_first_name": "PAYAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-575-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "60893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Paul
• Jane S. Paul
• Jean Marie Pauley, BIRTH DOULA
• Glenn Dale Paulson, RASI
• Kristine Louise Paulson
• Payne Family & Psychiatric Nursing, Inc.
• Brian William Payne, D.D.S.
• Celine Payne, MD
• Jacqueline Morgan Payne, DDS
• Lemlem W Payne, NURSE PRACTITIONER

• Dentist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.