Individual provider Active NPI

Laleh Mokhberi

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1689173718
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS107048 Issued in CA
Practice address
3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1405
Phone
(213) 235-2500
NPI assigned
Feb 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS107048 CA Primary

Addresses

Primary practice location

3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1405

Mailing address

3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1404
Phone (213) 235-2500

Other practice location 1

114 Granville Ave
Los Angeles, CA 90049-4225
Phone (949) 413-8401

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
I20221213001496 CA Practitioner - Dentist 6709255839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS107048CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Korean Health, Education, Information and Research Center CurrentSince Aug 11, 2022 Accepting new patients
Korean Health Education Information and Research Center CurrentSince Aug 11, 2022 Accepting new patients

Locations

3255 Wilshire Blvd
Ste 120
Los Angeles, CA 90010
Phone (213) 235-1212

3727 W 6th St
Ste 200
Los Angeles, CA 90020
Phone (213) 235-2500

3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500

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": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1689173718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101404",
            "telephone_number": "213-235-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101405",
            "telephone_number": "213-235-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Granville Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900494225",
            "country_code": "US",
            "telephone_number": "949-413-8401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOKHBERI",
        "first_name": "LALEH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS107048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.