Individual provider Active NPI

Denise S Miresmaili

  • General Practice Dentistry
  • Temecula, CA
National Provider Identifier
1962079863
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
108898 Issued in CA
Practice address
42210 Lyndie LN Ste B
Temecula, CA 92591-3604
Phone
(909) 230-2328
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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 108898 CA Primary

Addresses

Primary practice location

42210 Lyndie LN Ste B
Temecula, CA 92591-3604

Mailing address

714 Tiverton Ave
Los Angeles, CA 90095-8361

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
108898CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1962079863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 TIVERTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42210 LYNDIE LN STE B",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925913604",
            "telephone_number": "909-230-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRESMAILI",
        "first_name": "DENISE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.