Active NPI
Asal Kohandel-Shirazi, D.M.D.
- Dentist
- Fullerton, CA
National Provider Identifier
1598069791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56123
- Practice address
- 170 N Raymond Ave
Fullerton, CA 92831-4610 - Phone
- (714) 870-2000
- Fax
- (888) 801-0908
- NPI assigned
- Jan 3, 2011
- Sex
- Female
- 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 | 56123 | CA | Primary |
Addresses
Primary practice location
170 N Raymond Ave
Fullerton, CA 92831-4610
Mailing address
170 N Raymond Ave
Fullerton, CA 92831-4610
Phone (714) 870-2000
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 |
|---|---|---|---|
| 56123 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Alice Skuben D.D.S. | Past | Accepting new patients | |
| Asal Shirazi DMD, Inc. | Dentist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dentist
- Fullerton, CA
- NPI 1265776090
-
- General Practice Dentistry
- Fullerton, CA
- NPI 1003012881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294012800000",
"number": "1598069791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 N RAYMOND AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314610",
"telephone_number": "714-870-2000",
"fax_number": "888-801-0908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 N RAYMOND AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928314610",
"telephone_number": "714-870-2000",
"fax_number": "888-801-0908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHANDEL-SHIRAZI",
"first_name": "ASAL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-03",
"last_updated": "2011-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.