Mohammed Amir Khasru, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

48479 Issued in CA

Practice address

2160 S Waterman Ave Ste a
San Bernardino, CA 92408-3746

Phone

(909) 433-0029

Fax

(909) 433-0059

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

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

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205902251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S WATERMAN AVE STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083746",
            "telephone_number": "909-433-0029",
            "fax_number": "909-433-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S WATERMAN AVE STE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083746",
            "telephone_number": "909-433-0029",
            "fax_number": "909-433-0059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3027 W Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925453617",
            "country_code": "US",
            "telephone_number": "951-929-0582",
            "fax_number": "951-929-2793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3027 W Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925453617",
            "country_code": "US",
            "telephone_number": "951-929-0582",
            "fax_number": "951-929-2793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHASRU",
        "first_name": "MOHAMMED",
        "middle_name": "AMIR",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nadir O Khattab, DDS
• Omar Khayat, MD
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• Rawan Kheir, PT, MPT

• Dentist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.