Individual provider Active NPI

Bahareh Pouya, DDS

  • Orofacial Pain Dentistry
  • Los Angeles, CA
National Provider Identifier
1750269205
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
41820 Issued in TX
Practice address
10833 Le Conte Ave # Chs10157
Los Angeles, CA 90095-3075
Phone
(310) 794-1929
Fax
(310) 206-5302
NPI assigned
Aug 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 41820 TX Primary

Addresses

Primary practice location

10833 Le Conte Ave # Chs10157
Los Angeles, CA 90095-3075

Mailing address

10833 Le Conte Ave # Chs10157
Los Angeles, CA 90095-3075
Phone (323) 645-0599

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
I20251029001839 CA Practitioner - Dentist 4880183953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

808 W 58TH St
Los Angeles, CA 90037-3632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Oct 1, 2025 Accepting new patients
St. Johns Community Health CurrentSince Oct 1, 2025 Accepting new patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Organizations & group practices 4

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": "1755907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1750269205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE # CHS10157",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "323-645-0599",
            "fax_number": "310-206-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE # CHS10157",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-794-1929",
            "fax_number": "310-206-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUYA",
        "first_name": "BAHAREH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-23",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "TX",
            "license": "41820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.