Individual provider Active NPI

Morvarid Rouhani, DDS

  • General Practice Dentistry
  • Pasadena, CA
National Provider Identifier
1659452514
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43654 Issued in CA
Practice address
310 S Lake Ave Lowr Level
Pasadena, CA 91101-3537
Phone
(626) 795-6855
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43654 CA Primary

Addresses

Primary practice location

310 S Lake Ave Lowr Level
Pasadena, CA 91101-3537

Mailing address

24119 Lance PL
West Hills, CA 91307-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141209000291 CA Practitioner - Oral Surgery 1557683570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43654CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Leon D. Roisman, D.M.D., Inc. General Practice PastSince Nov 1, 2014 Accepting new patients
Community Dental Service Past Accepting new patients

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1659452514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24119 LANCE PL",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913071252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S LAKE AVE LOWR LEVEL",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013537",
            "telephone_number": "626-795-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUHANI",
        "first_name": "MORVARID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.