Active NPI
Mohamed Khaled, MSD
- Periodontics
- Oxnard, CA
National Provider Identifier
1174869515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 39369
- Practice address
- 140 N a St
Oxnard, CA 93030-5315 - Phone
- (818) 312-4530
- NPI assigned
- Dec 12, 2012
- Last updated
- Dec 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901020820 | MI | |
| Periodontics | 1223P0300X | 63881 | CA | |
| Periodontics | 1223P0300X | 39369 | TX | Primary |
Addresses
Primary practice location
140 N a St
Oxnard, CA 93030-5315
Mailing address
26500 Agoura Rd
Ste 102-468
Calabasas, CA 91302-1952
Phone (818) 312-4530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XXXXX | Other | XXX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63881 | CA | MD | Periodontist |
| 2901020820 | MI | MD | Periodontist |
| 39369 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Khaled Dental Corporation | Periodontics | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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dba Sterling Periodontics and Implantology
- Periodontics
- Beverly Hills, CA
- NPI 1639872153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1174869515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26500 AGOURA RD",
"address_2": "STE 102-468",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913021952",
"telephone_number": "818-312-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 N A ST",
"city": "OXNARD",
"state": "CA",
"postal_code": "930305315",
"telephone_number": "818-312-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALED",
"first_name": "MOHAMED",
"name_prefix": "Dr.",
"credential": "MSD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-12",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "2901020820",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "63881",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "39369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "XXX",
"identifier": "XXXXX",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxnard, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.