Active NPI
Fred Fahimy, D.D.S.
- Prosthodontics
- Huntington Beach, CA
National Provider Identifier
1891930657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 21122
- Practice address
- 17752 Beach Blvd
Suite 101
Huntington Beach, CA 92647-6838 - Phone
- (714) 848-1515
- NPI assigned
- Dec 9, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 21122 | CA | Primary |
Addresses
Primary practice location
17752 Beach Blvd
Suite 101
Huntington Beach, CA 92647-6838
Mailing address
17752 Beach Blvd
Suite 101
Huntington Beach, CA 92647-6838
Phone (714) 848-1515
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 |
|---|---|---|---|
| 21122 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228780800000",
"number": "1891930657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17752 BEACH BLVD",
"address_2": "SUITE 101",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926476838",
"telephone_number": "714-848-1515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17752 BEACH BLVD",
"address_2": "SUITE 101",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926476838",
"telephone_number": "714-848-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHIMY",
"first_name": "FRED",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-09",
"last_updated": "2008-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "21122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.