Farnoush Fadavi, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

45855 Issued in CA

Practice address

13001 Seal Beach Blvd Ste 310
Seal Beach, CA 90740-2757

Phone

(562) 431-1920

Fax

(562) 431-6134

NPI assigned

Mar 12, 2007

Sex

Female

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

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1376675504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 SEAL BEACH BLVD STE 310",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402757",
            "telephone_number": "562-431-1920",
            "fax_number": "562-431-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 SEAL BEACH BLVD STE 310",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402757",
            "telephone_number": "562-431-1920",
            "fax_number": "562-431-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADAVI",
        "first_name": "FARNOUSH",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "45855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elderberry Healthcare and Physical Therapy Inc.
• Islam Elsobky
• Miwa Tsuji Emi, MSW
• Espi Physical Therapy, Inc.
• George Raymond Espinoza
• Michael H Fanarof, O.D.
• Denise C Fanelli, MA, ATR, LMFT
• Robin Faustino Jr., PT, DPT
• Julia Ferguson
• Pascal Ferzli, M.D.

• Endodontics in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.