Shadi Mazaheri, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

62184 Issued in CA

Practice address

13400 Washington Blvd Ste 202B
Marina del Rey, CA 90292-5643

Phone

(213) 537-4231

NPI assigned

Mar 1, 2013

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

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.

• Mazaheri and Mazaheri Dental Partnership

  • General Practice Dentistry
  • Norwalk, CA
  • NPI 1396691465
  NPD Authorized official

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1598005498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 WASHINGTON BLVD STE 202B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925643",
            "telephone_number": "213-537-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 WASHINGTON BLVD STE 202B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925643",
            "telephone_number": "213-537-4231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZAHERI",
        "first_name": "SHADI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Matevosyan, D.D.S.
• Andrea Mathieux
• Ian Maxwell Matthews, PMHNP
• Vincent Mattiello
• Torbertha Pannor Maxwell, FNP-C
• Amy McManus, LMFT
• MDR Surgery Center, LLC
• Angela Meadows
• Medbil, LLC
• Medical Electrodiagnostics & Imaging Inc

• General Practice Dentistry in Marina del Rey, CA
• Providers in Marina del Rey, 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 Mar 28, 2013; 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.