Active NPI
Soheil Jourabchi, D.D.S
- General Practice Dentistry
- Huntington Park, CA
National Provider Identifier
1396857785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 42336
- Practice address
- 5600 Pacific Blvd
Suite#a
Huntington Park, CA 90255-2537 - Phone
- (323) 585-2100
- Fax
- (323) 585-6545
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 42336 | CA | Primary |
Addresses
Primary practice location
5600 Pacific Blvd
Suite#a
Huntington Park, CA 90255-2537
Mailing address
5600 Pacific Blvd
Suite#a
Huntington Park, CA 90255-2618
Phone (323) 585-2100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160520001723 | CA | Order and Referring Only - Dentist | 5890084479 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42336 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259884800000",
"number": "1396857785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5600 PACIFIC BLVD",
"address_2": "SUITE#A",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902552618",
"telephone_number": "323-585-2100",
"fax_number": "323-585-6545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5600 PACIFIC BLVD",
"address_2": "SUITE#A",
"city": "HUNTINGTON PARK",
"state": "CA",
"postal_code": "902552537",
"telephone_number": "323-585-2100",
"fax_number": "323-585-6545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOURABCHI",
"first_name": "SOHEIL",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2009-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "42336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Huntington Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.