Individual provider Active NPI

Ahmed Khocht, DDS

  • Periodontics
  • Loma Linda, CA
National Provider Identifier
1083669808
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
63142 Issued in CA
Practice address
Loma Linda University School of Dentistry
11092 Anderson St
Loma Linda, CA 92350-0001
Phone
(909) 558-4643
Fax
(909) 558-7959
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 63142 CA Primary

Addresses

Primary practice location

Loma Linda University School of Dentistry
11092 Anderson St
Loma Linda, CA 92350-0001

Mailing address

26630 Barton Rd
Apt 2713
Redlands, CA 92373-4323
Phone (706) 631-5680

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1083669808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26630 BARTON RD",
            "address_2": "APT 2713",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734323",
            "telephone_number": "706-631-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOMA LINDA UNIVERSITY SCHOOL OF DENTISTRY",
            "address_2": "11092 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4643",
            "fax_number": "909-558-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOCHT",
        "first_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "63142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.