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DR. OMID MIRFENDERESKI DDS, MPH
NPI 1891369641
Dentist - Pediatric Dentistry in San Rafael, CA

Active since May 17, 2021
3110 KERNER BLVD, SAN RAFAEL, CA 94901(415) 448-1500 Get Directions Write a Review

NPPES record last updated: June 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 16, 2024, Jun 18, 2021, May 17, 2021 (3 updates tracked since 2021).

About Dr. Omid Mirfendereski Dds, Mph NPPES

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

DR. OMID MIRFENDERESKI DDS, MPH (NPI 1891369641) is an individual pediatric dentistry provider in San Rafael, California, licensed in California (106243) and active in the NPI registry since May 2021.

NPPES Registry Identity

NPI1891369641
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. OMID MIRFENDERESKICredential: DDS, MPH
Location Address3110 KERNER BLVDSan Rafael, CA 94901-5411
Mailing AddressPo Box 3623Santa Clara, CA 95055-3623
Phone(415) 448-1500
Sole ProprietorNo
Enumeration DateMay 17, 2021
Last NPPES UpdateJune 16, 20243 updates tracked since enumeration
NPPES CertifiedJune 16, 2024
✔ NPI 1891369641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in CA · 106243
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
3110 KERNER BLVD, San Rafael, CA 94901
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, HRI Dental & Vision, Humana and more.Insurance ›

Other Providers at the Same Location NPPES 20

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

EUNKYO CHO DDS
Dentist (General Practice)
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 448-1500
EMMELINE LUI RDH
Dental Hygienist
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 448-1500
ALEXANDER DE JESUS CHAVARRIA
Social Worker (Clinical)
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 448-1500
DR. MARISSA WANG DMD
Dentist (General Practice)
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (626) 297-0068
JOANNA GOBEA FNP
Nurse Practitioner (Family)
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 755-2507
DR. PETER JOHN SIMON M.D.
Pediatrics
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 448-1500
ABIGAIL PEREZ ACSW
Social Worker (Clinical)
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 448-1500
MARIN COMMUNITY CLINIC
Clinic/Center (Federally Qualified Health Center (FQHC))
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Marin County (415) 526-8500

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 Omid Mirfendereski's NPI number?

The NPI number for Omid Mirfendereski is 1891369641. It was assigned to this individual provider in the NPPES registry on May 17, 2021.

Where is Omid Mirfendereski located?

Omid Mirfendereski practices at 3110 Kerner Blvd, San Rafael, CA 94901. The listed phone number is (415) 448-1500.

What is Omid Mirfendereski's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

What insurance does Omid Mirfendereski accept?

Health plans from BEST Life, HRI Dental & Vision, Humana, Paramount and Renaissance Dental and 1 other insurer list Omid Mirfendereski 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 Omid Mirfendereski was last updated on June 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.