{
"Npi": {
"NPI": "1962364216",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR A DANESHVAR DDS INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "77564 COUNTRY CLUB DR STE 350",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALM DESERT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92211-0450",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "720-772-7082",
"MailingAddressFaxNumber": "760-772-7085",
"FirstLinePracticeLocationAddress": "77564 COUNTRY CLUB DR STE 350",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PALM DESERT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92211-0450",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-772-7082",
"PracticeLocationAddressFaxNumber": "760-772-7085",
"EnumerationDate": "11/25/2025",
"LastUpdateDate": "11/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DANESHVAR MOZAFARI",
"AuthorizedOfficialFirstName": "AVIDEH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ DDS",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DDS",
"AuthorizedOfficialTelephoneNumber": "760-772-7082",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223D0001X",
"TaxonomyName": "Public Health Dentistry",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}