Active NPI
Jonathan Adam Kahn, DMD
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1083022164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 63745
- Practice address
- 1127 Wilshire Blvd
Suite 1504
Los Angeles, CA 90017-3901 - Phone
- (213) 201-1388
- NPI assigned
- Aug 1, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 63745 | CA | Primary |
Addresses
Primary practice location
1127 Wilshire Blvd
Suite 1504
Los Angeles, CA 90017-3901
Mailing address
354 N Ogden Dr
Los Angeles, CA 90036-2149
Phone (419) 283-8422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63745 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406851200000",
"number": "1083022164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "354 N OGDEN DR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900362149",
"telephone_number": "419-283-8422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 WILSHIRE BLVD",
"address_2": "SUITE 1504",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900173901",
"telephone_number": "213-201-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "JONATHAN",
"middle_name": "ADAM",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-01",
"last_updated": "2014-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "63745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.