Individual provider Active NPI

Benjamin Pourmorady

  • General Practice Dentistry
  • Beverly Hills, CA
National Provider Identifier
1447704580
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100433 Issued in CA
Practice address
144 N Willaman Dr
Beverly Hills, CA 90211-2113
Phone
(310) 801-5828
NPI assigned
Aug 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100433 CA
General Practice Dentistry 1223G0001X 100433 CA Primary

Addresses

Primary practice location

144 N Willaman Dr
Beverly Hills, CA 90211-2113

Mailing address

144 N Willaman Dr
Beverly Hills, CA 90211-2113
Phone (310) 801-5828

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170420001181 CA Order and Referring Only - DentistPractitioner - Dentist 6002192317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin Pourmorady DDS a Professional Corporation Inc. CurrentSince Nov 16, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1447704580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N WILLAMAN DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112113",
            "telephone_number": "310-801-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 N WILLAMAN DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112113",
            "telephone_number": "310-801-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURMORADY",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100433",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.