Individual provider Active NPI

Jossein Shahangian, DDS, MS

  • Pediatric Dentistry
  • San Diego, CA
National Provider Identifier
1639379142
Registry record updated Apr 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
59342 Issued in CA
Practice address
9840 Hibert St Ste B4
San Diego, CA 92131-1071
Phone
(858) 335-1165
NPI assigned
Jul 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 59342 CA Primary
Pediatric Dentistry 1223P0221X 8551 NC
Dentist 122300000X 150635 NC

Addresses

Primary practice location

9840 Hibert St Ste B4
San Diego, CA 92131-1071

Mailing address

9840 Hibert St
Suite B-4
San Diego, CA 92131-1071

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drj@scrippspd.com

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
150635NCMDDentist
59342CAMDPediatric Dentist
8551NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
S J Shahangian DDS Ms Inc Pediatric Dentistry CurrentSince May 10, 2020 Accepting new patients
S J Shahangian DDS Ms Inc Pediatric Dentistry PastSince Apr 17, 2020 Accepting new patients

Locations

9840 Hibert St
Ste B4
San Diego, CA 92131
Phone (858) 335-1165

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1639379142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9840 HIBERT ST",
            "address_2": "SUITE B-4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 HIBERT ST STE B4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311071",
            "telephone_number": "858-335-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHANGIAN",
        "first_name": "JOSSEIN",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "59342",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "8551",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "150635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drj@scrippspd.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "address_1": "9840 Hibert St Ste B4",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921311071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; 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.