KHASHAYAR KHODADADI DDS INC NPI 1003033556

Dentist (General Practice) in Los Angeles, CA

NPI 1003033556 Organization Dentist General Practice

About KHASHAYAR KHODADADI DDS INC

Khashayar Khodadadi Dds Inc is a provider established in Los Angeles, California specializing in dentist (general practice) . The NPI number of Khashayar Khodadadi Dds Inc is 1003033556 and was assigned on April 2007. The practitioner's primary taxonomy code is 1223G0001X with license number 43026 (CA). The provider is registered as an organization and their NPI record was last updated 11 years ago. Khashayar Khodadadi Dds Inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Khashayar Khodadadi D.d.s (President)

A dentist like Khashayar Khodadadi Dds Inc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

NPI

1003033556

Provider NameKHASHAYAR KHODADADI DDS INC
Provider Location Address11900 S. AVALON BLVD. SUITE 101 LOS ANGELES, CA 90061
Provider Mailing Address11900 S. AVALON BLVD. SUITE 101 LOS ANGELES, CA 90061
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-19-2007
Last Update Date06-14-2010


Primary Taxonomy

Taxonomy Code1223G0001X
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
License No.43026
License StateCA
Taxonomy DescriptionA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Business Address

KHASHAYAR KHODADADI DDS INC
11900 S. AVALON BLVD.
SUITE 101
LOS ANGELES, CA
ZIP 90061
Phone: (323) 834-0100
Fax: (323) 834-0101

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Mailing Address

KHASHAYAR KHODADADI DDS INC
11900 S. AVALON BLVD.
SUITE 101
LOS ANGELES, CA
ZIP 90061
Phone: (323) 834-0100
Fax: (323) 834-0101



Authorized Official

Authorized Official NameDR. KHASHAYAR KHODADADI D.D.S
Authorized Official TitlePRESIDENT
Authorized Official Phone(323) 834-0100

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
G93919-01OTHER (01)CA

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1598892184 JOSE RODRIGUEZ CCDC
Individual
Counselor (Addiction (Substance Use Disorder))11900 S. AVALON BLVD. SUITE 200
LOS ANGELES, CA 90061
(323) 242-0500
1114054731 KRISTEEN FRANCEEN ESQUIBEL CCDC
Individual
Counselor (Addiction (Substance Use Disorder))11900 S. AVALON BLVD. SUITE 200
LOS ANGELES, CA 90061
(323) 242-0500
1881722577 SUMMER NEAL
Individual
Counselor (Addiction (Substance Use Disorder))11900 S. AVALON BLVD. SUITE 200
LOS ANGELES, CA 90061
(323) 242-0500
1083743926 KHASHAYAR KHODADADI D.D.S
Individual
Dentist (General Practice)11900 S. AVALON BLVD. SUITE 101
LOS ANGELES, CA 90061
(323) 834-0100

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.