NPIMap

Organization Active NPI

Shawn Rabizadeh DDS2, a Professional Dental Corp.

Doing business as Palm Dental Care

  • Dentist
  • Camarillo, CA
National Provider Identifier
1538472311
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46324 Issued in CA
Legal business name
SHAWN RABIZADEH DDS2, A PROFESSIONAL DENTAL CORP.
Doing business as
Palm Dental Care
Practice address
2177 Ventura Blvd
Camarillo, CA 93010-7934
Phone
(805) 388-1048
NPI assigned
Jul 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Shawn Rabizadeh, DDS
Title
President
Phone
(805) 388-1048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 46324 CA Primary

Addresses

Primary practice location

2177 Ventura Blvd
Camarillo, CA 93010-7934

Mailing address

2177 Ventura Blvd
Camarillo, CA 93010-7934
Phone (805) 388-1048

Other names 1

  • PALM DENTAL CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1538472311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930107934",
            "telephone_number": "805-388-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 VENTURA BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930107934",
            "telephone_number": "805-388-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN RABIZADEH DDS2, A PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "RABIZADEH",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-388-1048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALM DENTAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.