Safoura Massoumi, DDS PEDIATRIC DENTIS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

40677 Issued in CA

Practice address

397 E St
Ste #a
Chula Vista, CA 91910

Phone

(619) 425-9930

Fax

(619) 425-9887

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Safoura Massouri Professional Dental Corp

  • Pediatric Dentistry
  • Chula Vista, CA
  • NPI 1306988118
  NPD (past) Authorized official
• Safoura Massoumi Professional Dental Corp.

  • Pediatric Dentistry
  • Chula Vista, CA
  • NPI 1356471460
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1497823561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 E ST",
            "address_2": "STE #A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-425-9930",
            "fax_number": "619-425-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 E ST",
            "address_2": "STE #A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-425-9930",
            "fax_number": "619-425-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSOUMI",
        "first_name": "SAFOURA",
        "credential": "DDS PEDIATRIC DENTIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "40677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9226501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara J Mase, M.S., CCC-SLP
• Joshua Masillamoni, D.D.S.
• Jessica Shanshan Maslin, M.D.
• Wendy Lee Mason, LVN
• Deema Soufi Massalkhi
• Andrew James Masters, PT, DPT
• Cari Mata
• Lauren Mata
• Kristen Laurel Mateo
• Kristin E Mather, OTR/L

• Pediatric Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.