NPIMap

Organization Active NPI

Rodrick Ghadimi DMD Inc

  • Dentist
  • Moorpark, CA
National Provider Identifier
1619254059
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52606 Issued in CA
Legal business name
RODRICK GHADIMI DMD INC
Practice address
484 E Los Angeles Ave
210
Moorpark, CA 93021-1900
Phone
(805) 532-1101
Fax
(805) 532-1834
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Authorized official

Name
Dr. Rodrick Ghadimi, DMD
Title
President
Phone
(805) 532-1101

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 52606 CA Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 52575 CA

Addresses

Primary practice location

484 E Los Angeles Ave
210
Moorpark, CA 93021-1900

Mailing address

484 E Los Angeles Ave
210
Moorpark, CA 93021-1900
Phone (805) 532-1101

Other names 1

  • Dental Smile Studio Doing business as

National Provider Directory

National Provider Directory

Locations

484 E Los Angeles Ave
Ste 210
Moorpark, CA 93021
Phone (805) 532-1101

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": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1619254059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 E LOS ANGELES AVE",
            "address_2": "210",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211900",
            "telephone_number": "805-532-1101",
            "fax_number": "805-532-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 E LOS ANGELES AVE",
            "address_2": "210",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211900",
            "telephone_number": "805-532-1101",
            "fax_number": "805-532-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODRICK GHADIMI DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "GHADIMI",
        "authorized_official_first_name": "RODRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-532-1101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52606",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "52575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Smile Studio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Smile Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.