Active NPI
Jamack Mozaffari, DDS
- Dentist
- Santa Monica, CA
National Provider Identifier
1871623686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55134
- Practice address
- 1902 California Ave # 101
Santa Monica, CA 90403-4440 - Phone
- (310) 383-0851
- NPI assigned
- Mar 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 55134 | CA | Primary |
Addresses
Primary practice location
1902 California Ave # 101
Santa Monica, CA 90403-4440
Mailing address
7455 Reseda Blvd Ste F
Reseda, CA 91335-7461
Phone (310) 383-0851
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 |
|---|---|---|---|
| 55134 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286928000000",
"number": "1871623686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7455 RESEDA BLVD STE F",
"city": "RESEDA",
"state": "CA",
"postal_code": "913357461",
"telephone_number": "310-383-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 CALIFORNIA AVE # 101",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904034440",
"telephone_number": "310-383-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOZAFFARI",
"first_name": "JAMACK",
"name_prefix": "Miss",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2010-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.