Individual provider Active NPI

Ali Vaziri, D.D.S.

  • Endodontics
  • Pacific Palisades, CA
National Provider Identifier
1669532925
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
39348 Issued in CA
Practice address
859 Via de la Paz
Suite C
Pacific Palisades, CA 90272-3664
Phone
(310) 230-8282
Fax
(310) 230-8292
NPI assigned
Dec 9, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 39348 CA Primary

Addresses

Primary practice location

859 Via de la Paz
Suite C
Pacific Palisades, CA 90272-3664

Mailing address

4125 Sepulveda Blvd
Culver City, CA 90230-4706
Phone (310) 391-6311

Other identifiers 1

IdentifierTypeStateIssuer
B39348-01MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
39348CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercedeh Motameni, O.D., an Optometric Corporation PastSince Dec 21, 2011 Accepting new patients

Organizations & group practices 1

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669532925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304706",
            "telephone_number": "310-391-6311",
            "fax_number": "310-390-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 VIA DE LA PAZ",
            "address_2": "SUITE C",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723664",
            "telephone_number": "310-230-8282",
            "fax_number": "310-230-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZIRI",
        "first_name": "ALI",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "39348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B39348-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.