Individual provider Active NPI

Farideh Taghilou Knapp, DDS

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1174680243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40255 Issued in CA
Practice address
6260 Santa Monica Blvd
Los Angeles, CA 90038-1704
Phone
(323) 465-9055
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40255 CA Primary

Addresses

Primary practice location

6260 Santa Monica Blvd
Los Angeles, CA 90038-1704

Mailing address

13600 Marina Pointe Dr Unit 1014
Marina del Rey, CA 90292-9252
Phone (310) 306-3381

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
I20150925001308 CA Order and Referring Only - DentistPractitioner - Dentist 6002124906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: fknapp@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174680243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13600 MARINA POINTE DR UNIT 1014",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902929252",
            "telephone_number": "310-306-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381704",
            "telephone_number": "323-465-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "FARIDEH",
        "middle_name": "TAGHILOU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.