Individual provider Active NPI

Farhang Shahzadi, DDS

  • Dentist
  • Aliso Viejo, CA
National Provider Identifier
1912249392
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47417 Issued in CA
Practice address
24541 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3065
Phone
(949) 292-2733
Fax
(949) 643-7049
NPI assigned
Mar 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47417 CA
Dentist 122300000X 47417 CA Primary

Addresses

Primary practice location

24541 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3065

Mailing address

24541 Pacific Park Dr
Suite 105
Aliso Viejo, CA 92656-3065
Phone (949) 292-2733

Other names 1

  • Dr. Frank Shahzadi Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191209001394 CA Practitioner - Oral SurgeryPractitioner - Dentist 2860825601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shahzadi Dental, a Professional Corporation Current Accepting new patients

Locations

24541 Pacific Park Dr
Ste 105
Aliso Viejo, CA 92656
Phone (949) 292-2733

Organizations & group practices 1

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": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1912249392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR",
            "address_2": "SUITE 105",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563065",
            "telephone_number": "949-292-2733",
            "fax_number": "949-643-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24541 PACIFIC PARK DR",
            "address_2": "SUITE 105",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563065",
            "telephone_number": "949-292-2733",
            "fax_number": "949-643-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHZADI",
        "first_name": "FARHANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-22",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47417",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FRANK",
            "last_name": "SHAHZADI",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.