NPIMap

Organization Active NPI

Heavenly Dental

  • Dentist
  • San Fernando, CA
National Provider Identifier
1790823698
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39149 Issued in CA
Legal business name
HEAVENLY DENTAL
Doing business as
Heavenly Dental
Practice address
321 N Maclay Ave
Suite a
San Fernando, CA 91340
Phone
(818) 837-9744
Fax
(818) 837-9303
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Noushin Fani, DDS
Title
Owner
Phone
(818) 837-9744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 39149 CA Primary

Addresses

Primary practice location

321 N Maclay Ave
Suite a
San Fernando, CA 91340

Mailing address

321 N Maclay Ave
Suite a
San Fernando, CA 91340
Phone (818) 837-9744

Other names 1

  • Heavenly Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790823698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N MACLAY AVE",
            "address_2": "SUITE A",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "91340",
            "telephone_number": "818-837-9744",
            "fax_number": "818-837-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MACLAY AVE",
            "address_2": "SUITE A",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "91340",
            "telephone_number": "818-837-9744",
            "fax_number": "818-837-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FANI",
        "authorized_official_first_name": "NOUSHIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-837-9744",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heavenly Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Fernando, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.