Individual provider Active NPI

David Esmall Shirazi, D.D.S.

  • Dentist
  • Thousand Oaks, CA
National Provider Identifier
1659422194
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48020 Issued in CA
Practice address
558 Saint Charles Dr
201
Thousand Oaks, CA 91360-3903
Phone
(805) 496-5700
Fax
(805) 496-5719
NPI assigned
Jan 12, 2007
Last updated
Jul 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48020 CA Primary
Acupuncturist 171100000X AC 11429 CA

Addresses

Primary practice location

558 Saint Charles Dr
201
Thousand Oaks, CA 91360-3903

Mailing address

558 Saint Charles Dr
201
Thousand Oaks, CA 91360-3903
Phone (805) 496-5700

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

LicenseStateTypeSpecialty
48020CAMDDentist
AC 11429CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
TMJ and Sleep Therapy Centre Current Accepting new patients
Sleep Diagnostics & Research Centre LLC PastSince Aug 29, 2013 Accepting new patients
TMJ and Sleep Therapy Centre of Conejo Valley Dentist Past Accepting new patients

Locations

555 Marin St
Ste 108
Thousand Oaks, CA 91360
Phone (805) 496-5700

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1659422194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 SAINT CHARLES DR",
            "address_2": "201",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603903",
            "telephone_number": "805-496-5700",
            "fax_number": "805-496-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SAINT CHARLES DR",
            "address_2": "201",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603903",
            "telephone_number": "805-496-5700",
            "fax_number": "805-496-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "DAVID",
        "middle_name": "ESMALL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48020",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 11429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.