Individual provider Active NPI

Ghodsieh Nili, D.M.D

  • General Practice Dentistry
  • Newport Beach, CA
National Provider Identifier
1952431959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
400 Newport Center Dr.
# 201
Newport Beach, CA 92660-7603
Phone
(949) 701-1430
Fax
(949) 719-1433
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

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 CA Primary

Addresses

Primary practice location

400 Newport Center Dr.
# 201
Newport Beach, CA 92660-7603

Mailing address

400 Newport Center Dr.
# 201
Newport Beach, CA 92660-7603
Phone (949) 701-1430

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
I20160714000615 CA Order and Referring Only - DentistPractitioner - Dentist 0941592760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33-0252281CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952431959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR.",
            "address_2": "# 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607603",
            "telephone_number": "949-701-1430",
            "fax_number": "949-719-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR.",
            "address_2": "# 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607603",
            "telephone_number": "949-701-1430",
            "fax_number": "949-719-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILI",
        "first_name": "GHODSIEH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.