Nima Ebrahimi, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

60241 Issued in CA

Practice address

11645 Wilshire Blvd Ste 1001
Los Angeles, CA 90025-6808

Phone

(310) 620-8140

NPI assigned

Oct 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 20, 2021 through Apr 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Nima Ebrahimi, D.D.S., Inc.

  • Periodontics
  • Los Angeles, CA
  • NPI 1013658210
  NPD Authorized official
• Steven Kaminsky DMD & Natasha Yashar DDS

  • Periodontics
  • Simi Valley, CA
  • NPI 1154754968
  NPD (past)

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

{
    "created_epoch": "1285977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1639488034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-620-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1001",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-620-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMI",
        "first_name": "NIMA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-02",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60241",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12011522A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028258",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "60241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Oby Ebo
• Ebony Group Incorporated
• Ebora Guest Home
• Deborah Ebrahemi
• Nahrin Veronica Ebrahimi
• Ramin Ebrahimi, MD
• Sasha Ebrahimi, MD PHD
• Rodney Ebrahimian, M.D.
• Sayna Ebrahimzadeh
• Jamshid Ebrami, PA-C

• Periodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.