Individual provider Active NPI

Shawyan Yazdanmehr, DDS

  • Dentist
  • San Diego, CA
National Provider Identifier
1902419468
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS110224 Issued in CA
Practice address
591 Camino de la Reina Ste 412
San Diego, CA 92108-3106
Phone
(312) 898-9249
NPI assigned
Aug 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS110224 CA Primary

Addresses

Primary practice location

591 Camino de la Reina Ste 412
San Diego, CA 92108-3106

Mailing address

591 Camino de la Reina Ste 412
San Diego, CA 92108-3106
Phone (312) 898-9249

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
DDS110224CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shawyan Yazdanmehr DDS PC Dentist CurrentSince Aug 25, 2025 Accepting new patients
David M. Allen D.D.S. and Associates, P.C. General Practice PastSince Aug 1, 2020 Accepting new patients
Ahmadi Dental Group General Practice PastSince Nov 1, 2024 Accepting new patients
Sleep Impressions, LLC Dentist PastSince Aug 1, 2020 Accepting new patients

Locations

591 Camino de la Reina
Ste 412
San Diego, CA 92108
Phone (619) 220-7475

Organizations & group practices 4

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": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1902419468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 412",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083106",
            "telephone_number": "312-898-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 412",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083106",
            "telephone_number": "312-898-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZDANMEHR",
        "first_name": "SHAWYAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-25",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS110224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.