1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Dentist
  6. NPI Profile

NIMA EBRAHIMI D.D.S.
NPI 1639488034
Dentist - Periodontics in Los Angeles, CA

Active since October 02, 2010Opted out of Medicare · through Apr 20, 2027
11645 WILSHIRE BLVD STE 1001, LOS ANGELES, CA 90025(310) 620-8140 Get Directions Write a Review

NPPES record last updated: April 4, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nima Ebrahimi D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIMA EBRAHIMI D.D.S. (NPI 1639488034) is an individual periodontics provider in Los Angeles, California, licensed in California (60241) and active in the NPI registry since October 2010. He has opted out of Medicare through April 20, 2027.

NPPES Registry Identity

NPI1639488034
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameNIMA EBRAHIMICredential: D.D.S.
Location Address11645 WILSHIRE BLVD STE 1001Los Angeles, CA 90025-6808
Mailing Address11645 Wilshire Blvd Ste 1001Los Angeles, CA 90025-6808 · (310) 620-8140
Phone(310) 620-8140
Sole ProprietorNo
Enumeration DateOctober 2, 2010
Last NPPES UpdateApril 4, 2022
NPPES CertifiedApril 4, 2022
✔ NPI 1639488034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in CA · 60241
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Also ListedDentistTaxonomy 122300000X · License 60241 (CA)
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 019.028258 (IL), 12011522A (IN)
11645 WILSHIRE BLVD STE 1001, Los Angeles, CA 90025
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nima Ebrahimi D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 20, 2021 through April 20, 2027.

Opt-Out Effective DateApril 20, 2021
Opt-Out In Effect ThroughApril 20, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIMA EBRAHIMI, D.D.S., INC.
Dentist (Periodontics)
11645 WILSHIRE BLVD STE 1001
LOS ANGELES, CA 90025
Los Angeles County (310) 620-8140

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nima Ebrahimi's NPI number?

The NPI number for Nima Ebrahimi is 1639488034. It was assigned to this individual provider in the NPPES registry on October 2, 2010.

Where is Nima Ebrahimi located?

Nima Ebrahimi practices at 11645 Wilshire Blvd Ste 1001, Los Angeles, CA 90025. The listed phone number is (310) 620-8140.

What is Nima Ebrahimi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Nima Ebrahimi enrolled in Medicare?

No. Nima Ebrahimi has opted out of Medicare through April 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Nima Ebrahimi accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list Nima Ebrahimi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nima Ebrahimi was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.