DR. OMAR KHOLAKI D.D.S., M.D.
NPI 1750738555
Dentist - Oral and Maxillofacial Surgery in Los Angeles, CA
About Dr. Omar Kholaki D.d.s., M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. OMAR KHOLAKI D.D.S., M.D. (NPI 1750738555) is an individual oral and maxillofacial surgery provider in Los Angeles, California, licensed in California (102062) and active in the NPI registry since May 2016. He has opted out of Medicare through July 17, 2028 and maintains a secondary practice location in Glendale.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted 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
Dr. Omar Kholaki D.d.s., M.d. 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 July 17, 2024 through July 17, 2028.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90067
LOS ANGELES, CA 90067
LOS ANGELES, CA 90067
LOS ANGELES, CA 90067
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 Omar Kholaki's NPI number?
The NPI number for Omar Kholaki is 1750738555. It was assigned to this individual provider in the NPPES registry on May 21, 2016.
Where is Omar Kholaki located?
Omar Kholaki practices at 2080 Century Park E Ste 610, Los Angeles, CA 90067. The listed phone number is (424) 209-4190.
What is Omar Kholaki's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Omar Kholaki enrolled in Medicare?
No. Omar Kholaki has opted out of Medicare through July 17, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Omar Kholaki 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 Omar Kholaki 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 Omar Kholaki was last updated on June 25, 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.
# Dr. Omar Kholaki, D.D.S., M.D. · NPI 1750738555
Oral and Maxillofacial Surgery provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since May 21, 2016.
## Identity
- **NPI:** 1750738555 (Entity type: Individual)
- **Enumerated:** May 21, 2016
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** 102062 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2080 CENTURY PARK E STE 610, Los Angeles, CA 90067-2009
- **Phone:** (424) 209-4190
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 17, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** June 25, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1750738555) · Data from the CMS NPPES public registry.