NPIMap

Organization Active NPI

Payam Behradnia Dmo, a Dental Corp

  • Dentist
  • Santa Rosa, CA
National Provider Identifier
1316332000
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Dr. Payam Behradnia, DENTIST
Title
Ceo
Phone
(707) 575-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 60893 CA Primary

Addresses

Primary practice location

4757 Hoen Ave
Santa Rosa, CA 95405-7862

Mailing address

4757 Hoen Ave
Santa Rosa, CA 95405-7862
Phone (707) 575-9595

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • 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.