Individual provider Active NPI

Shahin Shamsian

  • General Practice Dentistry
  • Tarzana, CA
National Provider Identifier
1730220104
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46961 Issued in CA
Practice address
5620 Wilbur Ave
Suite 309
Tarzana, CA 91356-1351
Phone
(818) 881-1559
Fax
(818) 881-3805
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 46961 CA Primary

Addresses

Primary practice location

5620 Wilbur Ave
Suite 309
Tarzana, CA 91356-1351

Mailing address

5620 Wilbur Ave
Suite 309
Tarzana, CA 91356-1351
Phone (818) 881-1559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230728003016 CA Practitioner - Oral Surgery 4082075817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46961CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shahin Shamsian D.D.S Inc CurrentSince Apr 13, 2023 Accepting new patients
Shahin Shamsian DDS Inc Current Accepting new patients

Locations

5620 Wilbur Ave
Ste 309
Tarzana, CA 91356
Phone (818) 881-1559

19228 Ventura Blvd
Unit C
Tarzana, CA 91356
Phone (310) 666-4882

Organizations & group practices 2

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730220104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE",
            "address_2": "SUITE 309",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561351",
            "telephone_number": "818-881-1559",
            "fax_number": "818-881-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE",
            "address_2": "SUITE 309",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561351",
            "telephone_number": "818-881-1559",
            "fax_number": "818-881-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMSIAN",
        "first_name": "SHAHIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.