Individual provider Active NPI

Parisa Tahmasebi

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1699693192
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
113089 Issued in CA
Practice address
3001 El Cajon Blvd Ste 101
San Diego, CA 92104-1387
Phone
(619) 704-0685
NPI assigned
Jul 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 113089 CA Primary

Addresses

Primary practice location

3001 El Cajon Blvd Ste 101
San Diego, CA 92104-1387

Mailing address

6166 Cornell LN
League City, TX 77573-2498

Other practice location 1

2050 El Cajon Blvd
San Diego, CA 92104-1007
Phone (619) 637-9774

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Hinderberger Dental Corporation General Practice PastSince Jul 21, 2024 Accepting new patients

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": "1783555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1699693192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6166 CORNELL LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EL CAJON BLVD STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041387",
            "telephone_number": "619-704-0685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 El Cajon Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921041007",
            "country_code": "US",
            "telephone_number": "619-637-9774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAHMASEBI",
        "first_name": "PARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.