Individual provider Active NPI

Bahram Danaei

  • General Practice Dentistry
  • Oxnard, CA
National Provider Identifier
1922502202
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104913 Issued in CA
Practice address
1100 W Gonzales Rd
Oxnard, CA 93036-3336
Phone
(805) 751-4656
Fax
(805) 973-8869
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104913 CA Primary

Addresses

Primary practice location

1100 W Gonzales Rd
Oxnard, CA 93036-3336

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
I20240405002603 CA Order and Referring Only - DentistPractitioner - Dentist 6901244136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc PastSince Mar 24, 2024 Accepting new patients
Clinicas del Camino Real Inc PastSince Mar 24, 2024 Accepting new patients
Steven G. Johnson Dental Corporation Dentist PastSince Jun 1, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bahram.danaei.p1@direct.clinicas.nextgenshare.com
  • Direct secure messaging: bdanaei802597@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1922502202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W GONZALES RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930363336",
            "telephone_number": "805-751-4656",
            "fax_number": "805-973-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANAEI",
        "first_name": "BAHRAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.