Assal Abdossalehi DDS Inc

Key facts

NPI

1689450140

Entity type

Organization (NPI type 2)

Primary specialty

Pediatric Dentistry 1223P0221X

Legal business name

ASSAL ABDOSSALEHI DDS INC

Practice address

4700 D St Ste D
Lakewood, CA 90712-2500

Phone

(617) 477-7729

NPI assigned

Aug 31, 2023

Organization subpart

No

Authorized official

Name

Assal Abdossalehi, DMD NPI 1447614599

Title

Owner Dentist

Phone

(617) 477-7729

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Assal Abdossalehi Pediatric Dentistry · Burbank, CA · NPI 1447614599
  NPD Authorized official PEDIATRIC DENTISTRY

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2023.

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1689450140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 D ST STE D",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122500",
            "telephone_number": "617-477-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 D ST STE D",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907122500",
            "telephone_number": "617-477-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSAL ABDOSSALEHI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "ABDOSSALEHI",
        "authorized_official_first_name": "ASSAL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "617-477-7729",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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