Individual provider Active NPI

Jonathan Adam Kahn, DMD

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1083022164
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63745 Issued in CA
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

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
63745CAMDGeneral 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.

Verify at the official NPI Registry.