NPIMap

Organization Active NPI

H. Reza Shahmohammadi, a Dental Corporation

Doing business as Hamlin Dental Group

  • Clinic/Center
  • Van Nuys, CA
National Provider Identifier
1700941655
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
B4130701 Issued in CA
Legal business name
H. REZA SHAHMOHAMMADI, A DENTAL CORPORATION
Doing business as
Hamlin Dental Group
Practice address
14401 Hamlin St
Van Nuys, CA 91401
Phone
(818) 782-6919
Fax
(818) 988-4632
NPI assigned
Dec 22, 2006
Last updated
Aug 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Authorized official

Name
Mr. Lacey Howell
Title
Manager
Phone
(818) 782-6919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X B4130701 CA Primary

Addresses

Primary practice location

14401 Hamlin St
Van Nuys, CA 91401

Mailing address

14401 Hamlin St
Van Nuys, CA 91401
Phone (818) 782-6919

Other identifiers 2

IdentifierTypeStateIssuer
4130701OtherCAMEDICAL PROVIDER
B.41307.01MedicaidCA

Other names 1

  • Hamlin Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
H Reza a Dental Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

14401 Hamlin St
Van Nuys, CA 91401
Phone (818) 782-6919

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1700941655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14401 HAMLIN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-782-6919",
            "fax_number": "818-988-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 HAMLIN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-782-6919",
            "fax_number": "818-988-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. REZA SHAHMOHAMMADI, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-782-6919",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "B4130701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER",
            "identifier": "4130701",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B.41307.01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hamlin Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.