Shaghayegh Khodadadzadeh

Primary specialty

DentistTaxonomy code 122300000X

License

63674 Issued in CA

Practice address

5350 White Oak Ave Apt 409
Encino, CA 91316-4531

Phone

(310) 429-4210

NPI assigned

Jul 19, 2014

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1073653630
  Medicare reassignment NPD
• St. Johns Community Health

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1073363768
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1174225429
  NPD
• St. Johns Community Health

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1780376947
  NPD (past)

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405728000000",
    "number": "1285041475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 WHITE OAK AVE APT 409",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164531",
            "telephone_number": "310-429-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 WHITE OAK AVE APT 409",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164531",
            "telephone_number": "310-429-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODADADZADEH",
        "first_name": "SHAGHAYEGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-19",
        "last_updated": "2014-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shabnam Khanideh, DMD
• Melvin Khaw, M.D.
• Patrick Khaziran, D.C.
• Keren Khazzam, MA. LMFT
• Artineh Khechooman
• Khodamrad Payman, M.D., Inc.
• Kathy Khoie, PH.D.
• Ronit Khoobbayan, PA-C
• Shabnam Khorsand
• Jay Khorsandi, D.D.S.

• Dentist in Encino, CA
• Providers in Encino, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.