Active NPI
Pedram Majbuleh
- Dentist
- Saint Louis, MO
National Provider Identifier
1528750197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110434
- Practice address
- 2424 S 9TH St Apt 133
Saint Louis, MO 63104-4722 - Phone
- (925) 309-9962
- NPI assigned
- May 23, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 110434 | CA | Primary |
Addresses
Primary practice location
2424 S 9TH St Apt 133
Saint Louis, MO 63104-4722
Mailing address
2424 S 9TH St Apt 133
Saint Louis, MO 63104-4722
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 |
|---|---|---|---|
| 110434 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1528750197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 S 9TH ST APT 133",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631044722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 S 9TH ST APT 133",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631044722",
"telephone_number": "925-309-9962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJBULEH",
"first_name": "PEDRAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-23",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.