Active NPI
Katayoun Mohajerani, DDS
- Pediatric Dentistry
- San Fernando, CA
National Provider Identifier
1952566564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 60068
- Practice address
- 777 Truman St
107
San Fernando, CA 91340-3382 - Phone
- (818) 838-6600
- NPI assigned
- Jul 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 054534 | NY | |
| Pediatric Dentistry | 1223P0221X | 11365 | CT | |
| Pediatric Dentistry | 1223P0221X | 60068 | CA | Primary |
Addresses
Primary practice location
777 Truman St
107
San Fernando, CA 91340-3382
Mailing address
777 Truman St
107
San Fernando, CA 91340-3382
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
| License | State | Type | Specialty |
|---|---|---|---|
| 054534 | NY | MD | Pediatric Dentist |
| 60068 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1952566564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 TRUMAN ST",
"address_2": "107",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913403382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 TRUMAN ST",
"address_2": "107",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913403382",
"telephone_number": "818-838-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAJERANI",
"first_name": "KATAYOUN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-23",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "054534",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "11365",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "60068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.