Active NPI
Ali Ghavibonihe, D.D.S
- Dentist
- Los Angeles, CA
National Provider Identifier
1376764001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49754
- Practice address
- 1835 S la Cienega Blvd
Los Angeles, CA 90035-4600 - Phone
- (310) 836-0300
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 49754 | CA | Primary |
Addresses
Primary practice location
1835 S la Cienega Blvd
Los Angeles, CA 90035-4600
Mailing address
4535 San Feliciano Dr
Woodland Hills, CA 91364-5037
Phone (818) 517-6330
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49754 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376764001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 SAN FELICIANO DR",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913645037",
"telephone_number": "818-517-6330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 S LA CIENEGA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900354600",
"telephone_number": "310-836-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAVIBONIHE",
"first_name": "ALI",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, 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.