NPIMap

Organization Active NPI

Shahrestani Sparks Marina Dentistry, PC

Doing business as Sparks Marina Dentistry

  • General Practice Dentistry
  • Sparks, NV
National Provider Identifier
1760861447
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SHAHRESTANI SPARKS MARINA DENTISTRY, PC
Doing business as
Sparks Marina Dentistry
Practice address
475 Sparks Blvd
Suite 101
Sparks, NV 89434-9002
Phone
(775) 359-1565
Fax
(775) 359-1597
NPI assigned
May 27, 2015
Last updated
May 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Authorized official

Name
Ali Shahrestani, CYNTHIA CASTILLO
Title
Credentialing Administrator
Phone
(714) 845-8704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

475 Sparks Blvd
Suite 101
Sparks, NV 89434-9002

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Sparks Marina Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

475 Sparks Blvd
Ste 101
Sparks, NV 89434
Phone (775) 359-1565

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1760861447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SPARKS BLVD",
            "address_2": "SUITE 101",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894349002",
            "telephone_number": "775-359-1565",
            "fax_number": "775-359-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHRESTANI SPARKS MARINA DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "SHAHRESTANI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
        "authorized_official_telephone_number": "714-845-8704",
        "authorized_official_credential": "CYNTHIA CASTILLO"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparks Marina Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.