Individual provider Active NPI

Aman Naziri, DDS

  • General Practice Dentistry
  • South Gate, CA
National Provider Identifier
1750420162
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38888 Issued in CA
Practice address
4186 Tweedy Blvd
South Gate, CA 90280
Phone
(323) 569-7131
Fax
(323) 569-7131
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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 38888 CA Primary

Addresses

Primary practice location

4186 Tweedy Blvd
South Gate, CA 90280

Mailing address

4186 Tweedy Blvd
South Gate, CA 90280
Phone (323) 569-7131

Other identifiers 1

IdentifierTypeStateIssuer
B3888801MedicaidCA

Other names 1

  • Dr. Aman Naziri Other name

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
I20190905000970 CA Practitioner - Dentist 6305175084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38888CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pedram Fakheri DMD Inc Past Accepting new patients

Organizations & group practices 1

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1750420162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4186 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "90280",
            "telephone_number": "323-569-7131",
            "fax_number": "323-569-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4186 TWEEDY BLVD",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "90280",
            "telephone_number": "323-569-7131",
            "fax_number": "323-569-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZIRI",
        "first_name": "AMAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B3888801",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMAN",
            "last_name": "NAZIRI",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Gate, CA

Sources for this page

Verify at the official NPI Registry.