Active NPI
Eric Razavi, D.D.S.
- Dentist
- Fresno, CA
National Provider Identifier
1790820561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 42945
- Practice address
- 1225 M St
Jail Medical Services, 2ND Floor
Fresno, CA 93721-1805 - Phone
- (559) 488-2867
- Fax
- (559) 488-3298
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42945 | CA | Primary |
Addresses
Primary practice location
1225 M St
Jail Medical Services, 2ND Floor
Fresno, CA 93721-1805
Mailing address
1225 M St
Jail Medical Services, 2ND Floor
Fresno, CA 93721-1805
Phone (559) 488-2867
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42945 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790820561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 M ST",
"address_2": "JAIL MEDICAL SERVICES, 2ND FLOOR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211805",
"telephone_number": "559-488-2867",
"fax_number": "559-488-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 M ST",
"address_2": "JAIL MEDICAL SERVICES, 2ND FLOOR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211805",
"telephone_number": "559-488-2867",
"fax_number": "559-488-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZAVI",
"first_name": "ERIC",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "42945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- 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.