Individual provider Active NPI

Mona Goodarzi, DDS

  • General Practice Dentistry
  • Irvine, CA
National Provider Identifier
1871725259
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58691 Issued in CA
Practice address
16300 Sand Canyon Ave
Suite 506
Irvine, CA 92618-3711
Phone
(949) 413-6300
NPI assigned
Aug 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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 58691 CA Primary

Addresses

Primary practice location

16300 Sand Canyon Ave
Suite 506
Irvine, CA 92618-3711

Mailing address

16300 Sand Canyon Ave
Suite 506
Irvine, CA 92618-3711
Phone (949) 413-6300

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
58691CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1871725259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE",
            "address_2": "SUITE 506",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183711",
            "telephone_number": "949-413-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE",
            "address_2": "SUITE 506",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183711",
            "telephone_number": "949-413-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODARZI",
        "first_name": "MONA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.