Individual provider Active NPI

Babak Ariannejad, DMD

  • Dentist
  • La Jolla, CA
National Provider Identifier
1982918140
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59452 Issued in CA
Practice address
6417 Caminito Formby
La Jolla, CA 92037-5811
Phone
(858) 583-4627
NPI assigned
Jul 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59452 CA Primary

Addresses

Primary practice location

6417 Caminito Formby
La Jolla, CA 92037-5811

Mailing address

6417 Caminito Formby
La Jolla, CA 92037-5811
Phone (858) 583-4627

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
I20150915003545 CA Order and Referring Only - DentistPractitioner - Dentist 1658688114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1982918140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6417 CAMINITO FORMBY",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375811",
            "telephone_number": "858-583-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 CAMINITO FORMBY",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920375811",
            "telephone_number": "858-583-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIANNEJAD",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.