Organization Active NPI

Khalifeh Dental Group

  • Orofacial Pain Dentistry
  • Los Angeles, CA
National Provider Identifier
1043056476
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
Legal business name
KHALIFEH DENTAL GROUP
Practice address
5757 Wilshire Blvd
PR5
Los Angeles, CA 90036-5810
Phone
(323) 933-3855
NPI assigned
Jul 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Authorized official

Name
Dr. Mohammad Khalifeh, DDSNPI 1417045931
Title
Ceo
Phone
(323) 933-3855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X2210X Primary

Addresses

Primary practice location

5757 Wilshire Blvd
PR5
Los Angeles, CA 90036-5810

Mailing address

5757 Wilshire Blvd
PR5
Los Angeles, CA 90036-5810
Phone (323) 933-3855

Other names 1

  • TMJ WELLNESS GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

5757 Wilshire Blvd
Ste PR5
Los Angeles, CA 90036
Phone (323) 933-3855

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720051200000",
    "number": "1043056476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PR5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-933-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 WILSHIRE BLVD",
            "address_2": "PR5",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365810",
            "telephone_number": "323-933-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALIFEH DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A",
        "authorized_official_last_name": "KHALIFEH",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-933-3855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TMJ WELLNESS GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.