Active NPI
Caroline Shahrzad Rezvani, D.D.S.
- Dentist
- Washington, DC
National Provider Identifier
1679744981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN1000435
- Practice address
- 1712 I St NW
Suite 600
Washington, DC 20006-3702 - Phone
- (202) 331-0655
- Fax
- (202) 331-8558
- NPI assigned
- Mar 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN1000435 | DC | Primary |
Addresses
Primary practice location
1712 I St NW
Suite 600
Washington, DC 20006-3702
Mailing address
1712 I St NW
Suite 600
Washington, DC 20006-3702
Phone (202) 331-0655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160223002224 | FL | Order and Referring Only - Other (Physician) | 7012212434 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN1000435 | DC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shastriji PLLC | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
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.
-
- General Practice Dentistry
- Washington, DC
- NPI 1891192902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1679744981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 I ST NW",
"address_2": "SUITE 600",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200063702",
"telephone_number": "202-331-0655",
"fax_number": "202-331-8558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1712 I ST NW",
"address_2": "SUITE 600",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200063702",
"telephone_number": "202-331-0655",
"fax_number": "202-331-8558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZVANI",
"first_name": "CAROLINE",
"middle_name": "SHAHRZAD",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-13",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "DEN1000435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.