Individual provider Active NPI

Andrew Beizaee, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1750563664
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50847 Issued in CA
Practice address
5421 Shannon Ridge LN
San Diego, CA 92130-4808
Phone
(181) 768-1357
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50847 CA Primary

Addresses

Primary practice location

5421 Shannon Ridge LN
San Diego, CA 92130-4808

Mailing address

5421 Shannon Ridge LN
San Diego, CA 92130-4808
Phone (181) 768-1357

Other names 1

  • Dr. Arash Andrew Beizaee 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
I20151005000970 CA Order and Referring Only - DentistPractitioner - Dentist 2961710322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50847CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: abeizaee18333@syhealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1750563664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 SHANNON RIDGE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304808",
            "telephone_number": "181-768-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 SHANNON RIDGE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921304808",
            "telephone_number": "181-768-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEIZAEE",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARASH",
            "last_name": "BEIZAEE",
            "middle_name": "ANDREW",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.