Individual provider Active NPI

Mina K Sharifi, D.D.S.

  • General Practice Dentistry
  • Encino, CA
National Provider Identifier
1477619575
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
B45190 Issued in CA
Practice address
16101 Ventura Blvd
Suite 350
Encino, CA 91436-2500
Phone
(310) 308-7884
NPI assigned
Dec 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X B45190 CA Primary

Addresses

Primary practice location

16101 Ventura Blvd
Suite 350
Encino, CA 91436-2500

Mailing address

8549 Wilshire Blvd
PMB #190
Beverly Hills, CA 90211-3104
Phone (310) 308-7884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
B45190CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1477619575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8549 WILSHIRE BLVD",
            "address_2": "PMB #190",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113104",
            "telephone_number": "310-308-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD",
            "address_2": "SUITE 350",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362500",
            "telephone_number": "310-308-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFI",
        "first_name": "MINA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-31",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "B45190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.