Individual provider Active NPI

Mehrdad Noori, DDS

  • General Practice Dentistry
  • South Gate, CA
National Provider Identifier
1588825863
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57118 Issued in CA
Practice address
8536 Long Beach Blvd Ste B
South Gate, CA 90280-2017
Phone
(323) 581-0754
NPI assigned
Jun 19, 2008
Last updated
Dec 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 57118 CA Primary

Addresses

Primary practice location

8536 Long Beach Blvd Ste B
South Gate, CA 90280-2017

Mailing address

8536 Long Beach Blvd Ste B
South Gate, CA 90280-2017
Phone (323) 581-0754

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

LicenseStateTypeSpecialty
57118CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
M. Noori, DDS, Inc. Current Accepting new patients

Locations

8536 Long Beach Blvd
Ste B
South Gate, CA 90280
Phone (323) 581-0754

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1588825863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8536 LONG BEACH BLVD STE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802017",
            "telephone_number": "323-581-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8536 LONG BEACH BLVD STE B",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802017",
            "telephone_number": "323-581-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOORI",
        "first_name": "MEHRDAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.