Pooyan Nasibi DDS Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

POOYAN NASIBI DDS INC

Doing business as

Montebello Children's Dentistry

Practice address

235 E Beverly Blvd
Montebello, CA 90640-3776

Phone

(323) 597-1195

NPI assigned

Apr 1, 2019

Last updated

Apr 1, 2019By 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

Pooyan Nasibi, DDSNPI 1457735565

Title

Owner Doctor

Phone

(323) 597-1195

Specialties & licenses 1

Addresses

Other names 1

• Montebello Children's Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pooyan Nasibi, DDS

  • Pediatric Dentistry
  • Los Angeles, CA
  • NPI 1457735565
  NPD Authorized official

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1457813339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403776",
            "telephone_number": "323-597-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403776",
            "telephone_number": "323-597-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOYAN NASIBI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "NASIBI",
        "authorized_official_first_name": "POOYAN",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "323-597-1195",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montebello Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Placencia, NURSE PRACTITIONER
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• Sarah Ponce, RN MSN CNS NP
• Roger Antonio Portillo
• Prescott C. Rasmussen, M.D.
• Sairwaa Tandee Prevost, M.D.
• Procare Home Health Agency Inc
• Rong Pu, NP

• Pediatric Dentistry in Montebello, CA
• Providers in Montebello, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.