Organization Active NPI

Suzanne Khalili DDS Inc

  • General Practice Dentistry
  • Huntington Park, CA
National Provider Identifier
1154773968
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41096 Issued in CA
Legal business name
SUZANNE KHALILI DDS INC
Practice address
2550 E Slauson Ave Ste K2
Huntington Park, CA 90255-2889
Phone
(213) 765-8161
Fax
(678) 716-1428
NPI assigned
Jul 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Suzanne Khalili, DENTIST
Title
Dentist
Phone
(310) 926-0352

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 41096 CA Primary

Addresses

Primary practice location

2550 E Slauson Ave Ste K2
Huntington Park, CA 90255-2889

Mailing address

9911 W Pico Blvd Ste 950
Los Angeles, CA 90035-2720
Phone (213) 765-8161

Other identifiers 1

IdentifierTypeStateIssuer
553914872OtherCADENTIST

National Provider Directory

National Provider Directory

Locations

2550 E Slauson Ave
Ste K2
Huntington Park, CA 90255
Phone (213) 765-8161

9911 W Pico Blvd
Ste 950
Los Angeles, CA 90035
Phone (213) 765-8161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1154773968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 W PICO BLVD STE 950",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352720",
            "telephone_number": "213-765-8161",
            "fax_number": "678-716-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E SLAUSON AVE STE K2",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552889",
            "telephone_number": "213-765-8161",
            "fax_number": "678-716-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE KHALILI DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "KHALILI",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "310-926-0352",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "553914872",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

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