Active NPI
Ali Ostadali Makhmalbaf
- Prosthodontics
- Los Angeles, CA
National Provider Identifier
1861640302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 59489
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0401412149 | VA | MD | Dentist |
| 59489 | CA | MD | Prosthodontist |
| 25978 | TX | MD | Prosthodontist |
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.