Payam Pezeshkian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51987 Issued in CA

Practice address

3528 W 1St St
Santa Ana, CA 92703-3302

Phone

(714) 839-8992

NPI assigned

Nov 30, 2006

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: payam.pezeshkian.p1@direct.omnifamilyhealth.nextgenshare.com

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1790852952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3430",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928343430",
            "telephone_number": "714-839-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 W 1ST ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033302",
            "telephone_number": "714-839-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZESHKIAN",
        "first_name": "PAYAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjelica Marie Petris
• Alisa Petrosyan
• Lauren Petrovic
• Peyman Tabrizi, MD Inc
• Maedeh Peyvandi
• Gholamhossei Pezeshkpour, MD
• Angelita Pezina, N.P.
• Adriana Pfeifer
• Elise Pfotenhauer, SLP
• Pham D.M.D. Dental Corporation

• General Practice Dentistry in Santa Ana, CA
• Providers in Santa Ana, 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 Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.