Individual provider Active NPI

Ramin Jay Rassouli, D.D.S.

  • General Practice Dentistry
  • Long Beach, CA
National Provider Identifier
1942329164
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44068 Issued in CA
Practice address
925 E San Antonio Dr
#15
Long Beach, CA 90807-2210
Phone
(562) 428-5963
Fax
(562) 428-3210
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 44068 CA Primary

Addresses

Primary practice location

925 E San Antonio Dr
#15
Long Beach, CA 90807-2210

Mailing address

925 E San Antonio Dr
#15
Long Beach, CA 90807-2210
Phone (562) 428-5963

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

LicenseStateTypeSpecialty
44068CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942329164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E SAN ANTONIO DR",
            "address_2": "#15",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072210",
            "telephone_number": "562-428-5963",
            "fax_number": "562-428-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E SAN ANTONIO DR",
            "address_2": "#15",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072210",
            "telephone_number": "562-428-5963",
            "fax_number": "562-428-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSOULI",
        "first_name": "RAMIN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.