NPIMap

Organization Active NPI

Santa Monica Dental,a Dr Shenavad Dental Group Corporation

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1720239668
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48377 Issued in CA
Legal business name
SANTA MONICA DENTAL,A DR SHENAVAD DENTAL GROUP CORPORATION
Practice address
11775 Santa Monica Blvd
Los Angeles, CA 90025-2843
Phone
(310) 444-1818
NPI assigned
Oct 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
Dr. Ramin Shenavad
Title
Owner
Phone
(310) 444-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 48377 CA Primary

Addresses

Primary practice location

11775 Santa Monica Blvd
Los Angeles, CA 90025-2843

Mailing address

11775 Santa Monica Blvd
Los Angeles, CA 90025-2843
Phone (310) 444-1818

Other names 1

  • Santa Monica Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

11775 Santa Monica Blvd
Los Angeles, CA 90025
Phone (310) 444-1818

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1720239668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11775 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252843",
            "telephone_number": "310-444-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11775 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252843",
            "telephone_number": "310-444-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA DENTAL,A DR SHENAVAD DENTAL GROUP CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "SHENAVAD",
        "authorized_official_first_name": "RAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-444-1818",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Monica Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

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