Active NPI
Shahram Sean Ashtiani, D.D.S.
- Dentist
- Mission Viejo, CA
National Provider Identifier
1629128897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54112
- Practice address
- 23482 Alicia Pkwy
Mission Viejo, CA 92691-2601 - Phone
- (614) 266-1584
- NPI assigned
- Jan 11, 2007
- Last updated
- Jun 14, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20907 | OH | |
| Dentist | 122300000X | 54112 | CA | Primary |
Addresses
Primary practice location
23482 Alicia Pkwy
Mission Viejo, CA 92691-2601
Mailing address
23482 Alicia Pkwy
Mission Viejo, CA 92691-2601
Phone (614) 266-1584
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20907 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1629128897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23482 ALICIA PKWY",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926912601",
"telephone_number": "614-266-1584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23482 ALICIA PKWY",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926912601",
"telephone_number": "614-266-1584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHTIANI",
"first_name": "SHAHRAM",
"middle_name": "SEAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "20907",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.