Active NPI
Daniel Ghorbani Mashoof, D.M.D.
- Dentist
- Hesperia, CA
National Provider Identifier
1497765713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS60273
- Practice address
- 12821 Main St Ste 150
Hesperia, CA 92345-9130 - Phone
- (760) 947-9853
- Fax
- (760) 956-7813
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DE00009770 | WA | |
| Dentist | 122300000X | DDS60273 | CA | Primary |
Addresses
Primary practice location
12821 Main St Ste 150
Hesperia, CA 92345-9130
Mailing address
12821 Main St Ste 150
Hesperia, CA 92345-9130
Phone (425) 213-6606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5045851 | Medicaid | WA |
Other names 1
- Mr. Hamid Reza Ghorbani
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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS60273 | CA | MD | Dentist |
| DE00009770 | WA | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Corporation of Louis Stromberg DDS | Past | Accepting new patients | |
| Pacific Seastar Dental PLLC | Past | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Hesperia, CA
- NPI 1225282494
-
- Dental Clinic/Center
- Bellevue, WA
- NPI 1992381560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1497765713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12821 MAIN ST STE 150",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923459130",
"telephone_number": "425-213-6606",
"fax_number": "425-643-3733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12821 MAIN ST STE 150",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923459130",
"telephone_number": "760-947-9853",
"fax_number": "760-956-7813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHOOF",
"first_name": "DANIEL",
"middle_name": "GHORBANI",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2023-08-22",
"certification_date": "2023-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "WA",
"license": "DE00009770",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS60273",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5045851",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HAMID",
"last_name": "GHORBANI",
"middle_name": "REZA",
"prefix": "MR.",
"credential": "D.M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.