Maryam Khoroushi

Primary specialty

DentistTaxonomy code 122300000X

License

112410 Issued in CA

Practice address

4340 East Jensen Avenue, Fresno, Ca 93725
Fresno, CA 93725

Phone

(800) 492-4227

Fax

(559) 646-6906

NPI assigned

Jul 4, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: maryam.khoroushi.1@17661.direct.athenahealth.com

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1053201798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 EAST JENSEN AVENUE,",
            "address_2": "FRESNO, CA",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93725",
            "telephone_number": "800-492-4227",
            "fax_number": "559-646-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 EAST JENSEN AVENUE, FRESNO, CA 93725",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93725",
            "telephone_number": "800-492-4227",
            "fax_number": "559-646-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOROUSHI",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "112410",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anoush Ann Khodaverdian, M.D.
• Pech Khoeun
• Hong Veng Khoeur, PA-C
• Monica Khokhar, MD
• Marie Khongman
• Jaspreet Kaur Khosa, PHARMD.
• Phaly Khoun, LCSW
• Mirouj Michael Khourouzian, PHARMD
• Hani Raoul Khouzam, M.D.
• Amarvir Khroud

• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.