Maryam Bakhtiyari, D.D.S Professional Dental Corp

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MARYAM BAKHTIYARI, D.D.S PROFESSIONAL DENTAL CORP

Practice address

1117 2ND St
Manhattan Beach, CA 90266-6834

Phone

(310) 372-6600

Fax

(310) 372-4290

NPI assigned

Sep 7, 2023

Organization subpart

No

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

Authorized official

Name

Aicha Bayrouk

Title

Insurance Biller

Phone

(310) 372-6600

Specialties & licenses 1

Addresses

Other names 1

• manhattan beach orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maryam Bakhtiyari, DDS

  • General Practice Dentistry
  • Manhattan Beach, CA
  • NPI 1447470885
  NPD

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1336925908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 2ND ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666834",
            "telephone_number": "310-372-6600",
            "fax_number": "310-372-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 2ND ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902666834",
            "telephone_number": "310-372-6600",
            "fax_number": "310-372-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYAM BAKHTIYARI, D.D.S PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "BAYROUK",
        "authorized_official_first_name": "AICHA",
        "authorized_official_title_or_position": "INSURANCE BILLER",
        "authorized_official_telephone_number": "310-372-6600"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "manhattan beach orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nikole Markow
• Susmitha Marneni, DDS
• Octavio Marquez Montoya, ATC
• Reed Maruyama, AMFT, AT
• Mary Bos, D.O., a Medical Corporation
• Camille Garcia Marzan, DC
• Emily E Masi, FNP-BC; PMHNP-BC
• Christian Mata
• Rincy Mathew, LMFT
• Marcia Matika, DPM

• Customized Equipment (DME) in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.