NPIMap

Organization Active NPI

Reza M Birjandi DDS a Professional Corporation

  • Dentist
  • Perris, CA
National Provider Identifier
1689863987
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38259 Issued in CA
Legal business name
REZA M BIRJANDI DDS A PROFESSIONAL CORPORATION
Practice address
1675 N Perris Blvd
Suite A1
Perris, CA 92571
Phone
(951) 657-2222
Fax
(951) 657-3582
NPI assigned
Oct 23, 2007
Last updated
Sep 19, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
RESA M BIRJANDIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Authorized official

Name
Dr. Reza Mohammad Birjandi, DDS
Title
Owner DDS
Phone
(951) 657-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38259 CA Primary

Addresses

Primary practice location

1675 N Perris Blvd
Suite A1
Perris, CA 92571

Mailing address

1675 N Perris Blvd
Suite A1
Perris, CA 92571
Phone (951) 657-2222

Other identifiers 1

IdentifierTypeStateIssuer
G9410102OtherCAMEDI CAL

Other names 1

  • Crossroads Family Dental Group Other name

National Provider Directory

National Provider Directory
Tax ID family
Reza M Birjandi Ddsa Professional Dental Corporation3 organizations share this tax ID, including this one
Part of
Reza M Birjandi Ddsa Professional Dental Corporation

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1675 N Perris Blvd
Ste A1
Perris, CA 92571
Phone (951) 657-2222

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1689863987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N PERRIS BLVD",
            "address_2": "SUITE A1",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "92571",
            "telephone_number": "951-657-2222",
            "fax_number": "951-657-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N PERRIS BLVD",
            "address_2": "SUITE A1",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "92571",
            "telephone_number": "951-657-2222",
            "fax_number": "951-657-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZA M BIRJANDI DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RESA M BIRJANDI",
        "enumeration_date": "2007-10-23",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "BIRJANDI",
        "authorized_official_first_name": "REZA",
        "authorized_official_middle_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "951-657-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "G9410102",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Family Dental Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Crossroads Family Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.