Individual provider Active NPI

Parish Paymon Sedghizadeh, DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • Los Angeles, CA
National Provider Identifier
1760488167
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
48677 Issued in CA
Practice address
925 W 34TH St
Den 4276
Los Angeles, CA 90089-0641
Phone
(213) 740-2704
Fax
(213) 740-2376
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 48677 CA Primary

Addresses

Primary practice location

925 W 34TH St
Den 4276
Los Angeles, CA 90089-0641

Mailing address

925 W 34TH St
Den 4276
Los Angeles, CA 90089-0641
Phone (213) 740-2704

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
I20071128000380 CA Practitioner - Oral Surgery 6406945484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
University of Southern CaliforniaGroup PAC ID 5597658633, 3 clinicians

Practice addresses (Care Compare)

925 W 34TH St
Suite 151
Los Angeles, CA 90089-2394
Phone (213) 740-3410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
48677CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Verdugo Hills Pharmacy Inc CurrentSince Jan 1, 2007 Accepting new patients
University of Southern California Oral and Maxillofacial Pathology CurrentSince Jan 1, 2007 Accepting new patients
Sedghizadeh D.D.S., Inc. Oral and Maxillofacial Pathology Current Accepting new patients

Locations

925 W 34th St
Rm 151
Los Angeles, CA 90089
Phone (213) 740-3410

Organizations & group practices 3

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1760488167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W 34TH ST",
            "address_2": "DEN 4276",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890641",
            "telephone_number": "213-740-2704",
            "fax_number": "213-740-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W 34TH ST",
            "address_2": "DEN 4276",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890641",
            "telephone_number": "213-740-2704",
            "fax_number": "213-740-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDGHIZADEH",
        "first_name": "PARISH",
        "middle_name": "PAYMON",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "48677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.