Marjaneh Moghimi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47527 Issued in CA

Practice address

13400 Washington Blvd Ste 202B
Marina del Rey, CA 90292-5643

Phone

(310) 827-2792

Fax

(310) 827-2795

NPI assigned

Dec 21, 2006

Sex

Female

Sole proprietor

No

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770647893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 WASHINGTON BLVD STE 202B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925643",
            "telephone_number": "310-827-2792",
            "fax_number": "310-827-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 WASHINGTON BLVD STE 202B",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925643",
            "telephone_number": "310-827-2792",
            "fax_number": "310-827-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHIMI",
        "first_name": "MARJANEH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Marina del Rey, CA
• Providers in Marina del Rey, 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.