Individual provider Active NPI

Amir Hossein Nikraz, D.D.S.

  • Dentist
  • San Clemente, CA
National Provider Identifier
1629027537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46118 Issued in CA
Practice address
439 N El Camino Real
Suite E
San Clemente, CA 92672-4700
Phone
(949) 366-1177
Fax
(949) 366-1143
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46118 CA Primary

Addresses

Primary practice location

439 N El Camino Real
Suite E
San Clemente, CA 92672-4700

Mailing address

439 N El Camino Real
Suite E
San Clemente, CA 92672-4700
Phone (949) 366-1177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329001444 CA Order and Referring Only - DentistPractitioner - Dentist 6800193319

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46118CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amir Nikraz DDS, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629027537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 N EL CAMINO REAL",
            "address_2": "SUITE E",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724700",
            "telephone_number": "949-366-1177",
            "fax_number": "949-366-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 N EL CAMINO REAL",
            "address_2": "SUITE E",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724700",
            "telephone_number": "949-366-1177",
            "fax_number": "949-366-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKRAZ",
        "first_name": "AMIR",
        "middle_name": "HOSSEIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.