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DR. ISAM HANNA KHOURY D.M.D.
NPI 1801952239
Dentist - Oral and Maxillofacial Surgery in Daly City, CA

Active since December 29, 2006Opted out of Medicare · through Mar 9, 2028
1500 SOUTHGATE AVE, #103, DALY CITY, CA 94015(650) 991-0999(650) 991-0918 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Isam Hanna Khoury D.m.d. NPPES

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

DR. ISAM HANNA KHOURY D.M.D. (NPI 1801952239) is an individual oral and maxillofacial surgery provider in Daly City, California, licensed in California (DP035922) and active in the NPI registry since December 2006. He has opted out of Medicare through March 9, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1801952239
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. ISAM HANNA KHOURYCredential: D.M.D.
Location Address1500 SOUTHGATE AVE, #103Daly City, CA 94015-2259
Mailing Address1500 Southgate Ave, #103Daly City, CA 94015-2259 · (650) 991-0999 · Fax (650) 991-0918
Phone(650) 991-0999
Fax(650) 991-0918
Sole ProprietorYes
Enumeration DateDecember 29, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1801952239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · DP035922
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1500 SOUTHGATE AVE, Daly City, CA 94015
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINU49010CA
MedicaidB35922-01CA

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. Isam Hanna Khoury D.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 March 9, 2018 through March 9, 2028.

Opt-Out Effective DateMarch 9, 2018
Opt-Out In Effect ThroughMarch 9, 2028Opt-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 94015 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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. MARY CATHERINE TAYLOR SIEBEL PHD
Psychologist (Clinical)
1500 SOUTHGATE AVE, SUITE 301
DALY CITY, CA 94015
San Mateo County (415) 455-9572
MAHASTI SAGHIZADEH DDS
Dentist (Periodontics)
1500 SOUTHGATE AVE, 208
DALY CITY, CA 94015
San Mateo County (650) 756-0938
EDWARD SUN M.D., INC.
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
1500 SOUTHGATE AVE, SUITE 115
DALY CITY, CA 94015
San Mateo County (650) 991-4466
DR. JOHN O LAI M.D.
Internal Medicine
1500 SOUTHGATE AVE, SUITE 115
DALY CITY, CA 94015
San Mateo County (650) 991-4463
JEFF GEE MD INC
Family Medicine
1500 SOUTHGATE AVE, SUITE 102
DALY CITY, CA 94015
San Mateo County (650) 755-3000
KEVIN MINGYIU WONG M.D.
Internal Medicine
1500 SOUTHGATE AVE, #115
DALY CITY, CA 94015
San Mateo County (650) 991-4466
PING H CHOW MD
Internal Medicine (Cardiovascular Disease)
1500 SOUTHGATE AVE, SUITE 207
DALY CITY, CA 94015
San Mateo County (650) 755-9108
DENNIS L. HAMBY, MD
Internal Medicine (Gastroenterology)
1500 SOUTHGATE AVE, 201
DALY CITY, CA 94015
San Mateo County (650) 997-0555

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 Isam Khoury's NPI number?

The NPI number for Isam Khoury is 1801952239. It was assigned to this individual provider in the NPPES registry on December 29, 2006.

Where is Isam Khoury located?

Isam Khoury practices at 1500 Southgate Ave #103, Daly City, CA 94015. The listed phone number is (650) 991-0999.

What is Isam Khoury's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Isam Khoury enrolled in Medicare?

No. Isam Khoury has opted out of Medicare through March 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Isam Khoury was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.