Active NPI
Raymond Safarkoolan, D.D.S.
- Dentist
- Sun Valley, CA
National Provider Identifier
1740665728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64769
- Practice address
- 9360 Sunland Park Dr Apt 6
Sun Valley, CA 91352-1661 - Phone
- (818) 212-6316
- NPI assigned
- Jul 20, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64769 | CA | Primary |
Addresses
Primary practice location
9360 Sunland Park Dr Apt 6
Sun Valley, CA 91352-1661
Mailing address
9360 Sunland Park Dr Apt 6
Sun Valley, CA 91352-1661
Phone (818) 212-6316
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170111002185 | CA | Order and Referring Only - Other (Physician) | 3173804812 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437350400000",
"number": "1740665728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9360 SUNLAND PARK DR APT 6",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913521661",
"telephone_number": "818-212-6316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9360 SUNLAND PARK DR APT 6",
"city": "SUN VALLEY",
"state": "CA",
"postal_code": "913521661",
"telephone_number": "818-212-6316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAFARKOOLAN",
"first_name": "RAYMOND",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.