Individual provider Active NPI

Cyrus M Akhbari I, D.M.D

  • Pediatric Dentistry
  • San Jose, CA
National Provider Identifier
1891847596
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
36724 Issued in CA
Practice address
1201 Park Ave
Suite#2
San Jose, CA 95126-2919
Phone
(408) 971-9990
Fax
(408) 971-6628
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 36724 CA Primary

Addresses

Primary practice location

1201 Park Ave
Suite#2
San Jose, CA 95126-2919

Mailing address

1201 Park Ave
Suite #2
San Jose, CA 95126-2919
Phone (408) 971-9990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130710000691 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7618117938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cyrus M. Akhbari D.M.D a Proffesional Dental Coorporation Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1891847596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PARK AVE",
            "address_2": "SUITE #2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262919",
            "telephone_number": "408-971-9990",
            "fax_number": "408-971-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PARK AVE",
            "address_2": "SUITE#2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262919",
            "telephone_number": "408-971-9990",
            "fax_number": "408-971-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKHBARI",
        "first_name": "CYRUS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "36724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.