Organization Active NPI

Daraie Dental Group Inc

  • General Practice Dentistry
  • Tarzana, CA
National Provider Identifier
1831661966
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DARAIE DENTAL GROUP INC
Practice address
5620 Wilbur Avenue Ste 300
Tarzana, CA 91356
Phone
(310) 616-6816
Fax
(818) 708-1396
NPI assigned
Dec 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Authorized official

Name
Kaveh Tom Daraie
Title
Officer
Phone
(310) 616-6816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5620 Wilbur Avenue Ste 300
Tarzana, CA 91356

Mailing address

5620 Wilbur Avenue Ste 300
Tarzana, CA 91356
Phone (310) 616-6816

National Provider Directory

National Provider Directory

Locations

5620 Wilbur Ave
Ste 300
Tarzana, CA 91356
Phone (310) 616-6816

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": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1831661966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVENUE STE 300",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "310-616-6816",
            "fax_number": "818-708-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVENUE STE 300",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "310-616-6816",
            "fax_number": "818-708-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARAIE DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "DARAIE",
        "authorized_official_first_name": "KAVEH TOM",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "310-616-6816"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.