Kourosh Abedini, D.D,S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45350 Issued in CA

Practice address

15739 La Subida Dr
Unit #7
Hacienda Heights, CA 91745-4579

Phone

(626) 961-7501

Fax

(626) 961-7501

NPI assigned

May 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750598561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15739 LA SUBIDA DR",
            "address_2": "UNIT #7",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454579",
            "telephone_number": "626-961-7501",
            "fax_number": "626-961-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15739 LA SUBIDA DR",
            "address_2": "UNIT #7",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454579",
            "telephone_number": "626-961-7501",
            "fax_number": "626-961-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEDINI",
        "first_name": "KOUROSH",
        "name_prefix": "Dr.",
        "credential": "D.D,S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Hacienda Heights, CA
• Providers in Hacienda Heights, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.