NPIMap

Organization Active NPI

Ariannejad and Pham Dental Corporation

  • Dentist
  • La Mesa, CA
National Provider Identifier
1760934871
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ARIANNEJAD AND PHAM DENTAL CORPORATION
Practice address
5620 Lake Murray Blvd
La Mesa, CA 91942-1981
Phone
(619) 324-4195
Fax
(619) 560-5434
NPI assigned
Oct 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Dr. Shahab Ariannejad, DMD
Title
Owner
Phone
(619) 324-4195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5620 Lake Murray Blvd
La Mesa, CA 91942-1981

Mailing address

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

Other names 1

  • La Mesa Modern Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

5620 Lake Murray Blvd
La Mesa, CA 91942
Phone (619) 324-4195

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1760934871",
    "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": "5620 LAKE MURRAY BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421981",
            "telephone_number": "619-324-4195",
            "fax_number": "619-560-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIANNEJAD AND PHAM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "ARIANNEJAD",
        "authorized_official_first_name": "SHAHAB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-324-4195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Mesa Modern Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.