Individual provider Active NPI

Mahnaz Zandi Hanjari, D.D.S

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1962647321
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
47215 Issued in CA
Practice address
2080 Century Park E Ste 1801
Los Angeles, CA 90067-2021
Phone
(310) 553-5754
Fax
(310) 553-5952
NPI assigned
Dec 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 47215 CA Primary

Addresses

Primary practice location

2080 Century Park E Ste 1801
Los Angeles, CA 90067-2021

Mailing address

2080 Century Park E Ste 1801
Los Angeles, CA 90067-2021
Phone (310) 553-5754

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
I20230310001776 CA Order and Referring Only - DentistPractitioner - Dentist 1052784121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mahnaz Zandi D.D.S. Corp Periodontics CurrentSince Oct 29, 2023 Accepting new patients
Jae G. Kim Professional Dental Corporation Past Accepting new patients
Nasiry Dental Corporation Past Accepting new patients

Locations

2080 Century Park E
Ste 1801
Los Angeles, CA 90067
Phone (310) 553-5754

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1962647321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 1801",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672021",
            "telephone_number": "310-553-5754",
            "fax_number": "310-553-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 1801",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672021",
            "telephone_number": "310-553-5754",
            "fax_number": "310-553-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDI HANJARI",
        "first_name": "MAHNAZ",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2023-10-24",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "47215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.