Individual provider Active NPI

Jean-Paul W Davis, DDS, MSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Tarzana, CA
National Provider Identifier
1376746024
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
54578 Issued in CA
Practice address
18399 Ventura Blvd
Suite #251
Tarzana, CA 91356-4233
Phone
(818) 345-5286
NPI assigned
Jun 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 54578 CA Primary

Addresses

Primary practice location

18399 Ventura Blvd
Suite #251
Tarzana, CA 91356-4233

Mailing address

20524 Ventura Blvd Apt 108
Woodland Hills, CA 91364-6218
Phone (818) 598-0718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
54578CAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Alexi Eyvazi, D.D.S., Inc. Past Accepting new patients
Anoosheh Shahkarami DDS Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376746024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20524 VENTURA BLVD APT 108",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913646218",
            "telephone_number": "818-598-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18399 VENTURA BLVD",
            "address_2": "SUITE #251",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913564233",
            "telephone_number": "818-345-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEAN-PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS, MSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "54578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.