NPIMap

Organization Active NPI

Mehran Fakheri DMD a Professional Dental Corporation

  • Dentist
  • Arleta, CA
National Provider Identifier
1366653164
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54426 Issued in CA
Legal business name
MEHRAN FAKHERI DMD A PROFESSIONAL DENTAL CORPORATION
Practice address
9722 Laurel Canyon Blvd
Arleta, CA 91331-4106
Phone
(818) 897-1234
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Mr. Mehran Fakheri, DMDNPI 1093850695
Title
Owner Dentist
Phone
(818) 897-1234

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 MULTIPLE SINGLE SPECIALTY GROUP 122300000X 54426 CA Primary

Addresses

Primary practice location

9722 Laurel Canyon Blvd
Arleta, CA 91331-4106

Mailing address

9722 Laurel Canyon Blvd
Arleta, CA 91331-4106
Phone (818) 897-1234

National Provider Directory

National Provider Directory

Locations

9722 Laurel Canyon Blvd
Arleta, CA 91331
Phone (310) 770-0165

Practitioners & affiliated clinicians

Practitioners 3

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1366653164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9722 LAUREL CANYON BLVD",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913314106",
            "telephone_number": "818-897-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9722 LAUREL CANYON BLVD",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913314106",
            "telephone_number": "818-897-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHRAN FAKHERI DMD A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "FAKHERI",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "818-897-1234",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "54426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arleta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.