Shahrzad Prater, D.M.D

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

LL-0108-06 Issued in NV

Practice address

1040 Tierra del Rey
Suite 203
Chula Vista, CA 91910-7865

Phone

(619) 421-8742

Fax

(619) 421-8800

NPI assigned

May 21, 2008

Last updated

Sep 24, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Shahrzad Shirani Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prater Dental Corporation

  dba Rancho Del Rey Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chula Vista, CA
  • NPI 1962864884
  NPD (past) Authorized official
• Rivero DMD, Inc

  dba The Dental Extraction Clinic

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1245987080
  NPD (past)

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1912164468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 TIERRA DEL REY",
            "address_2": "SUITE 203",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107865",
            "telephone_number": "619-421-8742",
            "fax_number": "619-421-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 TIERRA DEL REY",
            "address_2": "SUITE 203",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107865",
            "telephone_number": "619-421-8742",
            "fax_number": "619-421-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "SHAHRZAD",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "57070",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "LL-0108-06",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAHRZAD",
            "last_name": "SHIRANI",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ute Powell, RN, PHN
• Amanda Powers, PSYD
• Ravindra Prabhu, M.D.
• Malia Jazmin Prado
• Prater Dental Corporation (Rancho Del Rey Orthodontics)
• Volanda Kay Preacely
• Saul Preciado-Garcia
• Sayeli B Preciado
• Sayra Preciado
• Preferred Acupuncture Center

• Orthodontics and Dentofacial Orthopedics Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.