Individual provider Active NPI

Afsoon Barkhordar, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1093901944
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50570 Issued in CA
Practice address
6200 Wilshire Blvd
Suite #909
Los Angeles, CA 90048-5801
Phone
(323) 935-2111
Fax
(323) 935-2414
NPI assigned
Sep 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50570 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd
Suite #909
Los Angeles, CA 90048-5801

Mailing address

6200 Wilshire Blvd
Suite #909
Los Angeles, CA 90048-5801
Phone (323) 935-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140120000361 CA Practitioner - Oral Surgery 4688802614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Afsoon Barkhordar DDS Inc. Dentist CurrentSince Sep 10, 2013 Accepting new patients
Manuel G. Domantaydds, Inc Dentist PastSince Sep 10, 2013 Accepting new patients

Locations

6200 Wilshire Blvd
Ste 909
Los Angeles, CA 90048
Phone (310) 714-2770

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1093901944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE #909",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-935-2111",
            "fax_number": "323-935-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE #909",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-935-2111",
            "fax_number": "323-935-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKHORDAR",
        "first_name": "AFSOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.