Active NPI
Ehsan Mossavi, DDS
- Dentist
- Irvine, CA
National Provider Identifier
1912253444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61529
- Practice address
- 113 Waterworks Way Ste 260
Irvine, CA 92618-3169 - Phone
- (916) 239-5717
- NPI assigned
- Aug 2, 2012
- Sex
- Male
- 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 | 61529 | CA | Primary |
Addresses
Primary practice location
113 Waterworks Way Ste 260
Irvine, CA 92618-3169
Mailing address
11465 Tunnel Hill Way
Gold River, CA 95670-7223
Phone (916) 239-5717
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 |
|---|---|---|---|
| 61529 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1912253444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11465 TUNNEL HILL WAY",
"city": "GOLD RIVER",
"state": "CA",
"postal_code": "956707223",
"telephone_number": "916-239-5717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 WATERWORKS WAY STE 260",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183169",
"telephone_number": "916-239-5717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSAVI",
"first_name": "EHSAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-02",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.