Shahram Nouri, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48974 Issued in CA

Practice address

9318 Reseda Blvd
Northridge, CA 91324-2926

Phone

(818) 885-5200

Fax

(818) 885-0087

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shahram Nouri Dental Corp.

  • Dentist
  • Northridge, CA
  • NPI 1356587703
  NPD Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1912069170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9318 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242926",
            "telephone_number": "818-885-5200",
            "fax_number": "818-885-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9318 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242926",
            "telephone_number": "818-885-5200",
            "fax_number": "818-885-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURI",
        "first_name": "SHAHRAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northridge Vascular Center a Professional Medical Corporation
• Northridge Villa for Elderly Inc.
• Nosratullah Khajavi, D.O.
• Gary Notkin, PA, ATC
• Golnaz Nouri, D.O
• Noveir Dental Corporation
• NP Dianne Palasio LLC
• NSC Management Company, Inc. (Endeavor Surgical Center)
• Nshan D Dekeyan DPM
• Zoe Leilani Numa

• General Practice Dentistry in Northridge, CA
• Providers in Northridge, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.