DR. MORTEZA KHATIBZADEH
NPI 1295953925
Dentist in San Diego, CA

Q: What is Morteza Khatibzadeh's NPI number?

The NPI number for Morteza Khatibzadeh is 1295953925. It was assigned to this individual provider in the NPPES registry on April 20, 2007.

Q: What is Morteza Khatibzadeh's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since April 20, 2007PECOS Enrolled

4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105(619) 280-4213 Get Directions Write a Review

NPPES record last updated: December 20, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Morteza Khatibzadeh NPPES

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

DR. MORTEZA KHATIBZADEH (NPI 1295953925) is an individual dentist in San Diego, California, licensed in California (55489) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295953925

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. MORTEZA KHATIBZADEH

Location Address4060 FAIRMOUNT AVESan Diego, CA 92105-1608

Mailing Address4060 Fairmount AveSan Diego, CA 92105-1608 · (619) 280-4213

Phone(619) 280-4213

Sole ProprietorNo

Enumeration DateApril 20, 2007

Last NPPES UpdateDecember 20, 2013

✔ NPI 1295953925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 55489

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

4060 FAIRMOUNT AVE, San Diego, CA 92105

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Other Identifiers 1

MedicaidD55489CA

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

✔

Enrolled in Medicare (PECOS)

Dr. Morteza Khatibzadeh is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92105 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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 20

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

DR. DORA DOAN O.D.

Optometrist

4060 FAIRMOUNT AVE, OPTOMETRY DEPARTMENT
SAN DIEGO, CA 92105

San Diego County (619) 961-0803

DIANA P ALVAREZ MSW

Counselor (Mental Health)

4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105

San Diego County (619) 295-6047

KALEELAH RAE, NAJA MUHAMMAD

Student in an Organized Health Care Education/Training Program

4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105

San Diego County (619) 280-4213

DR. ADLA TESSIER M.D.

Internal Medicine

4060 FAIRMOUNT AVE, FAMILY PRACTICE
SAN DIEGO, CA 92105

San Diego County (619) 255-9155

CYNTHIA MIRANDA PSYD

Psychologist

4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105

San Diego County (619) 564-8765

TONYA DANIELLE DANIEL LCSW

Social Worker (Clinical)

4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105

San Diego County (619) 584-1612

SAMANTHA GOGGIN MD

Pediatrics

4060 FAIRMOUNT AVE, PEDIATRICS DEPARTMENT
SAN DIEGO, CA 92105

San Diego County (619) 255-9154

NYAKOACH LAM ACSW

Social Worker

4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105

San Diego County (619) 285-7097

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 Morteza Khatibzadeh's NPI number?

The NPI number for Morteza Khatibzadeh is 1295953925. It was assigned to this individual provider in the NPPES registry on April 20, 2007.

Where is Morteza Khatibzadeh located?

Morteza Khatibzadeh practices at 4060 Fairmount Ave, San Diego, CA 92105. The listed phone number is (619) 280-4213.

What is Morteza Khatibzadeh's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Morteza Khatibzadeh enrolled in Medicare?

Yes. Morteza Khatibzadeh is registered in the Medicare PECOS enrollment system.

What insurance does Morteza Khatibzadeh 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, HRI Dental & Vision and Humana and 3 other insurers list Morteza Khatibzadeh 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 Morteza Khatibzadeh was last updated on December 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.