Individual provider Active NPI

Ali Ostadali Makhmalbaf

  • Prosthodontics
  • Los Angeles, CA
National Provider Identifier
1861640302
Registry record updated Sep 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
59489 Issued in CA
Practice address
925 W 34TH St # 230
Los Angeles, CA 90089-0058
Phone
(714) 495-0414
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412149 VA
Prosthodontics 1223P0700X 59489 CA Primary
Prosthodontics 1223P0700X 25978 TX

Addresses

Primary practice location

925 W 34TH St # 230
Los Angeles, CA 90089-0058

Mailing address

442 S Paseo Serena
Anaheim, CA 92807-4214

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

LicenseStateTypeSpecialty
0401412149VAMDDentist
59489CAMDProsthodontist
25978TXMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315699200000",
    "number": "1861640302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 S PASEO SERENA",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928074214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W 34TH ST # 230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890058",
            "telephone_number": "714-495-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTADALI MAKHMALBAF",
        "first_name": "ALI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2011-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412149",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "59489",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "25978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2011; 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.