Individual provider Active NPI

Amirreza Rafaat, D.D.S.

  • General Practice Dentistry
  • Pico Rivera, CA
National Provider Identifier
1922126499
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS109722 Issued in CA
Practice address
9444 Slauson Ave
Pico Rivera, CA 90660-4748
Phone
(562) 656-2020
NPI assigned
Mar 26, 2007
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401410532 VA
General Practice Dentistry 1223G0001X 041410532 VA
General Practice Dentistry 1223G0001X DDS109722 CA Primary

Addresses

Primary practice location

9444 Slauson Ave
Pico Rivera, CA 90660-4748

Mailing address

9444 Slauson Ave
Pico Rivera, CA 90660-4748
Phone (562) 656-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160628000020 VA Order and Referring Only - DentistPractitioner - Dentist 2062703705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS109722CAMDGeneral Practice Dentistry
041410532VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rafaat Dental Corporation General Practice Current Accepting new patients
Amirreza Rafaat DDS PC Past Accepting new patients
Lansdowne Smile Desine Dentist Past Accepting new patients

Locations

9444 Slauson Ave
Pico Rivera, CA 90660
Phone (562) 656-2020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1922126499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9444 SLAUSON AVE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-656-2020",
            "fax_number": "562-656-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9444 SLAUSON AVE",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604748",
            "telephone_number": "562-656-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAAT",
        "first_name": "AMIRREZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410532",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "041410532",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS109722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pico Rivera, CA

Sources for this page

Verify at the official NPI Registry.