Individual provider Active NPI

Kamran Shahsavari, DDS

  • General Practice Dentistry
  • Santa Ana, CA
National Provider Identifier
1841485877
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55980 Issued in CA
Practice address
1936 E Deere Ave Ste 130
Santa Ana, CA 92705-5732
Phone
(949) 567-3116
Fax
(866) 666-9677
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 55980 CA Primary

Addresses

Primary practice location

1936 E Deere Ave Ste 130
Santa Ana, CA 92705-5732

Mailing address

1936 E Deere Ave Ste 130
Santa Ana, CA 92705-5732
Phone (949) 567-3116

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

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1841485877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 E DEERE AVE STE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055732",
            "telephone_number": "949-567-3116",
            "fax_number": "866-666-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 E DEERE AVE STE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055732",
            "telephone_number": "949-567-3116",
            "fax_number": "866-666-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHSAVARI",
        "first_name": "KAMRAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.