Beata Pezeshki, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59989 Issued in CA

Practice address

3467 Ardsley PL
Encino, CA 91436-4023

Phone

(818) 429-2536

NPI assigned

Nov 9, 2010

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1528369477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD",
            "address_2": "#325",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162805",
            "telephone_number": "818-788-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3467 ARDSLEY PL",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364023",
            "telephone_number": "818-429-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKI",
        "first_name": "BEATA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Allen Petersen, PSY.D.
• Kenneth P Peterson, MD
• Stephanie Marie Pettigrew
• Peyman Gravori, D.O. Inc., a Professional Medical Corporation (Advanced California Pain Relief)
• Cynthia Pezeshgian, NP
• Nancy Pezeshki, PHARM. D.
• Angela Quynh Giao Pham, M.D.
• Courtney Phan
• Pharmacy for Less Inc
• Kiumars Pharrahpur, L.AC.

• General Practice Dentistry in Encino, CA
• Providers in Encino, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.