Nazanin Ezzati, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46790 Issued in CA

Practice address

18740 Ventura Blvd
#304
Tarzana, CA 91356-3366

Phone

(818) 881-9293

NPI assigned

Jul 16, 2008

Last updated

Jul 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1740444942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD",
            "address_2": "#304",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563366",
            "telephone_number": "818-881-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18740 VENTURA BLVD",
            "address_2": "#304",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563366",
            "telephone_number": "818-881-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZZATI",
        "first_name": "NAZANIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46790",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Express Reliable Diagnostic Inc
• Ariga Eyvazi
• Ezlinkmeds Pharmacy, Inc.
• Joseph Ezra, MD
• Alexander Ezzati, LAC
• Neil D Fagen, MD
• Jeremy Fain
• Azita Fakheri, MD
• Amita Firouzi Fakhimi, PSY.D.
• Sayel S. Fakhoury, D.C.

• General Practice Dentistry in Tarzana, CA
• Providers in Tarzana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.