Active NPI
Maryam Nakisa
- Dentist
- Artesia, CA
National Provider Identifier
1982586780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 113297
- Practice address
- 17721 Norwalk Blvd
Artesia, CA 90701-4355 - Phone
- (562) 410-3544
- NPI assigned
- Jul 23, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 113297 | CA | Primary |
Addresses
Primary practice location
17721 Norwalk Blvd
Artesia, CA 90701-4355
Mailing address
17721 Norwalk Blvd Unit 7
Artesia, CA 90701-4356
Phone (562) 410-3544
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1982586780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17721 NORWALK BLVD UNIT 7",
"city": "ARTESIA",
"state": "CA",
"postal_code": "907014356",
"telephone_number": "562-410-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17721 NORWALK BLVD",
"city": "ARTESIA",
"state": "CA",
"postal_code": "907014355",
"telephone_number": "562-410-3544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKISA",
"first_name": "MARYAM",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-23",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "113297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Artesia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.