Individual provider Active NPI

Golnaz Kavand

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Perris, CA
National Provider Identifier
1326531658
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
106090 Issued in CA
Practice address
3150 Case Rd BLDG C
Perris, CA 92570-5552
Phone
(951) 345-4386
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 106090 CA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 30.024640 OH
General Practice Dentistry 1223G0001X 30.024640 OH

Addresses

Primary practice location

3150 Case Rd BLDG C
Perris, CA 92570-5552

Mailing address

3838 Dunn Dr Apt 608
Culver City, CA 90232-2776
Phone (319) 400-3949

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
30.024640OHMDGeneral Practice Dentistry
106090CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kavand & Golla Dental Partnership Current Accepting new patients
Mercer and Pham Dental Corporation General Practice PastSince Apr 11, 2021 Accepting new patients

Organizations & group practices 2

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1326531658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 DUNN DR APT 608",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902322776",
            "telephone_number": "319-400-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CASE RD BLDG C",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925705552",
            "telephone_number": "951-345-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVAND",
        "first_name": "GOLNAZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "106090",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30.024640",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024640",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.