Shahriar Alex Rassoulian, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

47311 Issued in CA

Practice address

2 Mareblu
Suite 220
Aliso Viejo, CA 92656-3035

Phone

(949) 600-7575

Fax

(949) 600-7578

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356374342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MAREBLU",
            "address_2": "SUITE 220",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563035",
            "telephone_number": "949-600-7575",
            "fax_number": "949-600-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MAREBLU",
            "address_2": "SUITE 220",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563035",
            "telephone_number": "949-600-7575",
            "fax_number": "949-600-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSOULIAN",
        "first_name": "SHAHRIAR",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "47311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Ragazzo Jr.
• Vandana Rajula, MPT
• Erika Daniella Ramirez
• Amy Rangel
• Linda Mau Rappaport, LCSW
• Lauren Rawlins, SLP
• Re-Active Physical Therapy and Performance
• Rehabcare Group East, LLC
• Reiley Chiropractic a Professional Chiropractic Corporation
• James Reiley

• Endodontics in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.