Individual provider Active NPI

Ouzhan Behmardi Kalantari, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Irvine, CA
National Provider Identifier
1932635794
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
103150 Issued in CA
Practice address
16300 Sand Canyon Ave Ste 701
Irvine, CA 92618-3707
Phone
(949) 727-4633
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103150 CA
General Practice Dentistry 1223G0001X 30.025167 OH
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D011330 AZ
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 103250 CA
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 103150 CA Primary

Addresses

Primary practice location

16300 Sand Canyon Ave Ste 701
Irvine, CA 92618-3707

Mailing address

16300 Sand Canyon Ave Ste 701
Irvine, CA 92618-3707
Phone (949) 727-4633

Other practice location 1

11100 Euclid Ave
University Hospitals Cleveland Medical Center
Cleveland, OH 44106
Phone (216) 368-1168

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
I20260512003577 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5991189904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30.025167OHMDGeneral Practice Dentistry
103250CAMDPediatric Dentist
D011330AZMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1932635794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE STE 701",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183707",
            "telephone_number": "949-727-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE STE 701",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183707",
            "telephone_number": "949-727-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_2": "University Hospitals Cleveland Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "44106",
            "country_code": "US",
            "telephone_number": "216-368-1168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALANTARI",
        "first_name": "OUZHAN",
        "middle_name": "BEHMARDI",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103150",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025167",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D011330",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "103250",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "103150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.