Individual provider Active NPI

Ramin Khalili, DDS

  • Endodontics
  • Los Angeles, CA
National Provider Identifier
1033302914
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
56650 Issued in CA
Practice address
1330 Longworth Dr
Los Angeles, CA 90049-3629
Phone
(310) 621-0687
NPI assigned
Aug 23, 2007
Last updated
Jan 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 052298 NY
Endodontics 1223E0200X 56650 CA Primary

Addresses

Primary practice location

1330 Longworth Dr
Los Angeles, CA 90049-3629

Mailing address

1330 Longworth Dr
Los Angeles, CA 90049-3629
Phone (310) 621-0687

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
I20151102002567 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4880904929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56650CAMDEndodontist
052298NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ramin Khalili, DDS, Inc. Endodontics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1033302914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 LONGWORTH DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493629",
            "telephone_number": "310-621-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LONGWORTH DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493629",
            "telephone_number": "310-621-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALILI",
        "first_name": "RAMIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "052298",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "56650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.