Mohsen Roshanaei, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

54196 Issued in CA

Practice address

1131 E Main St # 110
Tustin, CA 92780-4416

Phone

(661) 252-3522

NPI assigned

Oct 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Roshanaei Dental Corporation

  • General Practice Dentistry
  • Canyon Country, CA
  • NPI 1124382817
  NPD (past) Authorized official

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1508045394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6063",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926166063",
            "telephone_number": "661-252-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 E MAIN ST # 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804416",
            "telephone_number": "661-252-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSHANAEI",
        "first_name": "MOHSEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54196",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rondinelli, MASTER EDUCATION
• Rony Huang DDS Inc
• Jeanette Rosales Briseno
• Tatiana Rosales
• Barbara Rosen, PH.D.
• Mina Roshanker, D.C.
• Melissa J Rosin, M.D.
• Shahin Rostami, RD
• Laura Rothafel, M.A.
• Elizabeth Rothstein, PT, DPT

• Dentist in Tustin, CA
• Providers in Tustin, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.