Organization Active NPI

Mojdeh Fatemi D.D.S., a Corporation

  • Dentist
  • Maywood, CA
National Provider Identifier
1639620990
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
45857 Issued in CA
Legal business name
MOJDEH FATEMI D.D.S., A CORPORATION
Practice address
5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944
Phone
(323) 771-7226
NPI assigned
Oct 20, 2016
Last updated
Oct 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Dr. Mojdeh Fatemi, D.D.S.NPI 1801085782
Title
Dentist
Phone
(323) 771-7226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 45857 CA Primary

Addresses

Primary practice location

5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944

Mailing address

5707 Atlantic Blvd
Ste. A1
Maywood, CA 90270-2944

National Provider Directory

National Provider Directory
Tax ID family
Mojdeh Fatemi DDS a Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5707 Atlantic Blvd
Ste A1
Maywood, CA 90270
Phone (323) 771-7226

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1639620990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 ATLANTIC BLVD",
            "address_2": "STE. A1",
            "city": "MAYWOOD",
            "state": "CA",
            "postal_code": "902702944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 ATLANTIC BLVD",
            "address_2": "STE. A1",
            "city": "MAYWOOD",
            "state": "CA",
            "postal_code": "902702944",
            "telephone_number": "323-771-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOJDEH FATEMI D.D.S., A CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "FATEMI",
        "authorized_official_first_name": "MOJDEH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-771-7226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.