Shahbod Rassoulian, D

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN14482 Issued in FL

Practice address

11401 Pines Blvd
Suite 220
Pembroke Pines, FL 33026

Phone

(954) 432-5515

Fax

(954) 432-8908

NPI assigned

Jun 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447455225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 BRICKELL KEY BLVD",
            "address_2": "SUITE 3311",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313711",
            "telephone_number": "305-373-4664",
            "fax_number": "954-432-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 PINES BLVD",
            "address_2": "SUITE 220",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33026",
            "telephone_number": "954-432-5515",
            "fax_number": "954-432-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSOULIAN",
        "first_name": "SHAHBOD",
        "credential": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN14482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Ramzi
• Dustin Jeff Randall
• Michelle Rangel, RN
• Bernadette Ranieri
• Elijah Abraham Rashti, DO
• Urairong Rattanakorn, N.P.
• Lisa Helene Rauch, RRT
• Raul Daza, M.D., P.a.
• Tanya-Ann Marie Rausch, APRN
• Regina Ravachi, LMHC

• Endodontics in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.