Individual provider Active NPI

Shefagh S Darabi, DDS

  • Dentist
  • Orange, CA
National Provider Identifier
1477859056
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59923 Issued in CA
Practice address
245 N Glassell St # a
Orange, CA 92866-1408
Phone
(714) 532-5600
NPI assigned
Jan 31, 2011
Last updated
Sep 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59923 CA Primary

Addresses

Primary practice location

245 N Glassell St # a
Orange, CA 92866-1408

Mailing address

245 N Glassell St # a
Orange, CA 92866-1408
Phone (714) 532-5600

Other practice location 1

12586 Ave. 408
Orosi, CA 93647-9454
Phone (559) 528-2804

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
I20160426001971 CA Order and Referring Only - DentistPractitioner - Dentist 9335448380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59923CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
J Kwon DMD Inc PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1477859056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N GLASSELL ST # A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661408",
            "telephone_number": "714-532-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N GLASSELL ST # A",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661408",
            "telephone_number": "714-532-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12586 Ave. 408",
            "address_purpose": "LOCATION",
            "city": "Orosi",
            "state": "CA",
            "postal_code": "936479454",
            "country_code": "US",
            "telephone_number": "559-528-2804",
            "fax_number": "559-528-7623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARABI",
        "first_name": "SHEFAGH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.