Individual provider Active NPI

Shiva Pouya, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1962382994
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
112297 Issued in CA
Practice address
500 Landfair Ave
Los Angeles, CA 90024-2104
Phone
(682) 554-4400
NPI assigned
Sep 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 112297 CA
General Practice Dentistry 1223G0001X 112297 CA Primary

Addresses

Primary practice location

500 Landfair Ave
Los Angeles, CA 90024-2104

Mailing address

500 Landfair Ave
Los Angeles, CA 90024-2104

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
112297CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1962382994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LANDFAIR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANDFAIR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242104",
            "telephone_number": "682-554-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POUYA",
        "first_name": "SHIVA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "112297",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.