NPIMap

Organization Active NPI

Edmond Rassibi, D.M.D., Professional Corporation

  • Dentist
  • Canoga Park, CA
National Provider Identifier
1346633716
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54596 Issued in CA
Legal business name
EDMOND RASSIBI, D.M.D., PROFESSIONAL CORPORATION
Practice address
21712 Sherman Way
Canoga Park, CA 91303-1931
Phone
(818) 883-6634
Fax
(818) 839-5626
NPI assigned
Mar 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Dr. Edmond Rassibi, DMDNPI 1265571350
Title
Ceo
Phone
(818) 883-6634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 54596 CA Primary

Addresses

Primary practice location

21712 Sherman Way
Canoga Park, CA 91303-1931

Mailing address

21712 Sherman Way
Canoga Park, CA 91303-1931
Phone (818) 883-6634

National Provider Directory

National Provider Directory

Locations

21712 Sherman Way
Canoga Park, CA 91303
Phone (818) 883-6634

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1346633716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21712 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031931",
            "telephone_number": "818-883-6634",
            "fax_number": "818-839-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21712 SHERMAN WAY",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031931",
            "telephone_number": "818-883-6634",
            "fax_number": "818-839-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMOND RASSIBI, D.M.D., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "RASSIBI",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-883-6634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "54596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.