H.Imankhan,DDS,Adc

Primary specialty

DentistTaxonomy code 122300000X

License

46073 Issued in CA

Legal business name

H.IMANKHAN,DDS,ADC

Practice address

23111 Ventura Blvd
104
Woodland Hills, CA 91364-1103

Phone

(818) 225-7768

Fax

(818) 225-1138

NPI assigned

Jun 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Hamid Reza Imankhan, D.D.S.

Title

President/Owner

Phone

(818) 225-7768

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1144480096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD",
            "address_2": "104",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641103",
            "telephone_number": "818-225-7768",
            "fax_number": "818-225-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23111 VENTURA BLVD",
            "address_2": "104",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641103",
            "telephone_number": "818-225-7768",
            "fax_number": "818-225-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.IMANKHAN,DDS,ADC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "IMANKHAN",
        "authorized_official_first_name": "HAMID",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "818-225-7768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "46073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G92843",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.