Mehdi Moradiseresht, D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MEHDI MORADISERESHT, D.D.S., INC.

Doing business as

Canoga Park Family Dentistry

Practice address

20935 Vanowen St Ste 207
Canoga Park, CA 91303-3806

Phone

(818) 918-6595

NPI assigned

Jan 10, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Mehdi MoradisereshtNPI 1093283855

Title

Owner/ Provider

Phone

(818) 918-6595

Specialties & licenses 1

Addresses

Other names 1

• Canoga Park Family 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.

• Mehdi Moradiseresht

  • Dentist
  • Woodland Hills, CA
  • NPI 1093283855
  NPD Authorized official

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1477363463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20935 VANOWEN ST STE 207",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033806",
            "telephone_number": "818-918-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20935 VANOWEN ST STE 207",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033806",
            "telephone_number": "818-918-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHDI MORADISERESHT, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "MORADISERESHT",
        "authorized_official_first_name": "MEHDI",
        "authorized_official_title_or_position": "OWNER/ PROVIDER",
        "authorized_official_telephone_number": "818-918-6595",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canoga Park Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Interpreter Network LLC
• Medicina Familiar
• Daniel Medina
• Oswaldo Medina
• Abigail Mediodia
• Connor Meisen
• Julissa Mejia
• Sylvia Mejia
• Tebei Lorenzo Melaitau
• Daisy Melchor Aquino

• General Practice Dentistry in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.