Shams and Nabizadeh Dental Corporation

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

56712 Issued in CA

Legal business name

SHAMS AND NABIZADEH DENTAL CORPORATION

Doing business as

winnetka dental practice

Practice address

7111 Winnetka Ave
Suite #3
Winnetka, CA 91306-3646

Phone

(818) 676-0970

NPI assigned

Nov 2, 2009

Last updated

Nov 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamir Nisan Shams, DMD

Title

Dentist

Phone

(818) 676-0970

Specialties & licenses 2

Addresses

Other names 1

• winnetka dental practice Doing business as

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1417283078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE #3",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913063646",
            "telephone_number": "818-676-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 WINNETKA AVE",
            "address_2": "SUITE #3",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913063646",
            "telephone_number": "818-676-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMS AND NABIZADEH DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "SHAMS",
        "authorized_official_first_name": "TAMIR",
        "authorized_official_middle_name": "NISAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-676-0970",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "56712",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "56220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "winnetka dental practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Maintenance Organization in Winnetka, CA
• Providers in Winnetka, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.