Active NPI
Shahrooz Saidian, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1386071546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62654
- Practice address
- 1817 Selby Ave
403
Los Angeles, CA 90025-5782 - Phone
- (310) 801-1095
- NPI assigned
- Oct 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 62654 | CA | Primary |
Addresses
Primary practice location
1817 Selby Ave
403
Los Angeles, CA 90025-5782
Mailing address
1817 Selby Ave
#403
Los Angeles, CA 90025-5782
Phone (310) 801-1095
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 |
|---|---|---|---|
| 62654 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421884800000",
"number": "1386071546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1817 SELBY AVE",
"address_2": "#403",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900255782",
"telephone_number": "310-801-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1817 SELBY AVE",
"address_2": "403",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900255782",
"telephone_number": "310-801-1095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAIDIAN",
"first_name": "SHAHROOZ",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-03",
"last_updated": "2015-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62654",
"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 Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.