NPIMap

Organization Active NPI

Fard & Mastour Dental Group

  • Dentist
  • Encino, CA
National Provider Identifier
1740694249
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48007 Issued in CA
Legal business name
FARD & MASTOUR DENTAL GROUP
Practice address
15720 Ventura Blvd
Suite 514
Encino, CA 91436-2914
Phone
(818) 990-6659
NPI assigned
Jun 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Authorized official

Name
Arash Sabbagh Fard, DDS
Title
President
Phone
(818) 990-6659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 48007 CA Primary

Addresses

Primary practice location

15720 Ventura Blvd
Suite 514
Encino, CA 91436-2914

Mailing address

15720 Ventura Blvd
Suite 514
Encino, CA 91436-2914
Phone (818) 990-6659

Other identifiers 1

IdentifierTypeStateIssuer
48007OtherCALICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1740694249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "address_2": "SUITE 514",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-990-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15720 VENTURA BLVD",
            "address_2": "SUITE 514",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362914",
            "telephone_number": "818-990-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARD & MASTOUR DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "SABBAGH FARD",
        "authorized_official_first_name": "ARASH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-990-6659",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "48007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "48007",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.