Individual provider Active NPI

Sadaf Sadighi Khandan, DDS

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1083443659
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110397 Issued in CA
Practice address
1810 Malcolm Ave
Los Angeles, CA 90025-7607
Phone
(323) 636-6051
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 110397 CA Primary

Addresses

Primary practice location

1810 Malcolm Ave
Los Angeles, CA 90025-7607

Mailing address

1810 Malcolm Ave Apt 304
Los Angeles, CA 90025-7611
Phone (323) 636-6051

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

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1083443659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MALCOLM AVE APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257611",
            "telephone_number": "323-636-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MALCOLM AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257607",
            "telephone_number": "323-636-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDAN",
        "first_name": "SADAF",
        "middle_name": "SADIGHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110397",
            "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 Jul 31, 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.