NPIMap

Organization Active NPI

Keyvan Bamshad D.D.S., Inc.

  • General Practice Dentistry
  • Reseda, CA
National Provider Identifier
1972940252
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46553 Issued in CA
Legal business name
KEYVAN BAMSHAD D.D.S., INC.
Practice address
19231 Victory Blvd Ste 458
Reseda, CA 91335-6368
Phone
(818) 345-6477
Fax
(818) 345-1509
NPI assigned
May 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Authorized official

Name
Dr. Keyvan Bamshad, D.D.S.
Title
Dentist/Owner
Phone
(818) 345-6477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 46553 CA Primary

Addresses

Primary practice location

19231 Victory Blvd Ste 458
Reseda, CA 91335-6368

Mailing address

19231 Victory Blvd Ste 458
Reseda, CA 91335-6368
Phone (818) 345-6477

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1972940252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD STE 458",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356368",
            "telephone_number": "818-345-6477",
            "fax_number": "818-345-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19231 VICTORY BLVD STE 458",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913356368",
            "telephone_number": "818-345-6477",
            "fax_number": "818-345-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYVAN BAMSHAD D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "BAMSHAD",
        "authorized_official_first_name": "KEYVAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "818-345-6477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; 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.