Active NPI
Avishan K Nasiri, DMD
- Dentist
- Santa Ana, CA
National Provider Identifier
1902286552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64535
- Practice address
- Boutique Family Dentistry
801 N Tustin Ave Ste 504
Santa Ana, CA 92705 - Phone
- (714) 550-0500
- Fax
- (714) 550-9560
- NPI assigned
- Jun 8, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 64535 | CA | Primary |
Addresses
Primary practice location
Boutique Family Dentistry
801 N Tustin Ave Ste 504
Santa Ana, CA 92705
Mailing address
2144 S Bristol St
Children'S Dental Group
Santa Ana, CA 92704
Phone (949) 981-5601
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 |
|---|---|---|---|
| 64535 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laila L. Malek DDS Inc | Dentist | Past | Accepting new patients |
| Avishan K. Nasiri, DMD, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Santa Ana, CA
- NPI 1336683549
-
- Dentist
- Santa Ana, CA
- NPI 1245631472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508889600000",
"number": "1902286552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2144 S BRISTOL ST",
"address_2": "CHILDREN'S DENTAL GROUP",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "92704",
"telephone_number": "949-981-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BOUTIQUE FAMILY DENTISTRY",
"address_2": "801 N TUSTIN AVE STE 504",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "92705",
"telephone_number": "714-550-0500",
"fax_number": "714-550-9560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASIRI",
"first_name": "AVISHAN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-08",
"last_updated": "2017-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.