Individual provider Active NPI

Javid Faran Osafi, DMD

  • Pediatric Dentistry
  • Temecula, CA
National Provider Identifier
1679019681
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE60745079 Issued in WA
Practice address
29645 Rancho California Rd Ste 229
Temecula, CA 92591-5285
Phone
(425) 223-3522
NPI assigned
Jan 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D011969 AZ
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X DE60745079 WA Primary
General Practice Dentistry 1223G0001X 101292 CA

Addresses

Primary practice location

29645 Rancho California Rd Ste 229
Temecula, CA 92591-5285

Mailing address

4980 Barranca Pkwy Ste 206
Irvine, CA 92604-8655
Phone (702) 612-0687

Other practice location 1

4980 Barranca Pkwy Ste 206
Irvine, CA 92604-8655
Phone (702) 612-0687

Other identifiers 1

IdentifierTypeStateIssuer
2080083MedicaidWA

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
D011969AZMDGeneral Practice Dentistry
DE60745079WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Javid Osafi DMD Inc Current Accepting new patients

Locations

4980 Barranca Pkwy
Ste 206
Irvine, CA 92604
Phone (702) 612-0687

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1679019681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4980 BARRANCA PKWY STE 206",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926048655",
            "telephone_number": "702-612-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29645 RANCHO CALIFORNIA RD STE 229",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915285",
            "telephone_number": "425-223-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4980 Barranca Pkwy Ste 206",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926048655",
            "country_code": "US",
            "telephone_number": "702-612-0687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSAFI",
        "first_name": "JAVID",
        "middle_name": "FARAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-13",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011969",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60745079",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080083",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.