NPIMap

Organization Active NPI

Keivan Sarraf, DDS, Inc

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1386811271
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52466 Issued in CA
Legal business name
KEIVAN SARRAF, DDS, INC
Practice address
5703 S Vermont Ave
Los Angeles, CA 90037-3930
Phone
(310) 460-9546
NPI assigned
May 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Dr. Keivan Sarraf, DDSNPI 1154410256
Title
Ceo
Phone
(310) 460-9546

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 52466 CA Primary

Addresses

Primary practice location

5703 S Vermont Ave
Los Angeles, CA 90037-3930

Mailing address

10600 Wilshire Blvd Apt 406
Los Angeles, CA 90024-4561
Phone (310) 460-9546

Other identifiers 1

IdentifierTypeStateIssuer
G89663MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Keivan Sarraf DDS Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5703 S Vermont Ave
Los Angeles, CA 90037
Phone (310) 460-9546

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1386811271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 WILSHIRE BLVD APT 406",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244561",
            "telephone_number": "310-460-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5703 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373930",
            "telephone_number": "310-460-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEIVAN SARRAF, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-11",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SARRAF",
        "authorized_official_first_name": "KEIVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-460-9546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G89663",
            "state": "CA"
        }
    ],
    "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 Jun 16, 2008; 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.