Individual provider Active NPI

Reza Rasekhi, D.D.S.

  • General Practice Dentistry
  • Orange, CA
National Provider Identifier
1386767481
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52106 Issued in CA
Practice address
665 N Tustin St
Suite W
Orange, CA 92867-7146
Phone
(714) 289-8100
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52106 CA Primary

Addresses

Primary practice location

665 N Tustin St
Suite W
Orange, CA 92867-7146

Mailing address

665 N Tustin St
Suite W
Orange, CA 92867-7146
Phone (714) 289-8100

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
52106CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1386767481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 N TUSTIN ST",
            "address_2": "SUITE W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677146",
            "telephone_number": "714-289-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 N TUSTIN ST",
            "address_2": "SUITE W",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928677146",
            "telephone_number": "714-289-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASEKHI",
        "first_name": "REZA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.