Benyamin Taghvaei, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

109575 Issued in CA

Practice address

44407 Challenger Way
Lancaster, CA 93535-3237

Phone

(703) 424-5816

NPI assigned

Aug 1, 2022

Reactivated

Nov 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1932836988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44407 CHALLENGER WAY",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935353237",
            "telephone_number": "703-424-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGHVAEI",
        "first_name": "BENYAMIN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-27",
        "deactivation_date": "2023-11-06",
        "reactivation_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043818",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.