Individual provider Active NPI

Alireza Khoshvaghti, DDS

  • Dentist
  • San Francisco, CA
National Provider Identifier
1003243049
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60385 Issued in CA
Practice address
220 Montgomery St Ste 483
San Francisco, CA 94104-3410
Phone
(415) 398-6344
NPI assigned
Oct 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15302 MD
Dentist 122300000X 15302 VA
Dentist 122300000X 60385 CA Primary

Addresses

Primary practice location

220 Montgomery St Ste 483
San Francisco, CA 94104-3410

Mailing address

220 Montgomery St Ste 483
San Francisco, CA 94104-3410
Phone (415) 398-6344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151117001346 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0345550695

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15302MDMDDentist
15302VAMDDentist
60385CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Alireza Khoshvaghti DDS Inc CurrentSince Apr 26, 2020 Accepting new patients

Locations

220 Montgomery St
Ste 483
San Francisco, CA 94104
Phone (415) 398-6344

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1003243049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 MONTGOMERY ST STE 483",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941043410",
            "telephone_number": "415-398-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MONTGOMERY ST STE 483",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941043410",
            "telephone_number": "415-398-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHVAGHTI",
        "first_name": "ALIREZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-04",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15302",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "15302",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.