Manijeh Khorshidi, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3729-015 Issued in WI

Practice address

1135 S Cesar E Chavez Dr
Milwaukee, WI 53204-2266

Phone

(414) 645-4540

NPI assigned

Jul 29, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998

  General Practice

  NPD (past)

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013921394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 MAC HENRY CIR # A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453636",
            "telephone_number": "262-794-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042266",
            "telephone_number": "414-645-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORSHIDI",
        "first_name": "MANIJEH",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3729-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33695300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monika Aneja Khiani, M.D.
• Jayant Khitha, MD
• Aymen M Khogali, MD
• Muhammad Khokhar, MD
• Sumaiya Khondker, M.D.
• Ibrahim Abdel Qader Ibrahim Khrais, M.D.
• Jessica S Khy, PHARMD
• Robyn Kibler, RDH
• Kilah M Kichura, PAC
• Colleen Kickbush

• General Practice Dentistry in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.