Soheil Khodadadi DMD, DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39024 Issued in CA

Legal business name

SOHEIL KHODADADI DMD, DDS, INC.

Doing business as

Hemet Dental Care

Practice address

1300 E Florida Ave
Space #A20
Hemet, CA 92544-8640

Phone

(951) 765-5544

Fax

(951) 765-5511

NPI assigned

Aug 14, 2007

Last updated

Aug 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Soheil Khodadadi, DMD, DDS

Title

Owner/Ceo

Phone

(951) 765-5544

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hemet Dental Care Doing business as

Locations

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187049600000",
    "number": "1295927275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E FLORIDA AVE",
            "address_2": "SPACE #A20",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925448640",
            "telephone_number": "951-765-5544",
            "fax_number": "951-765-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E FLORIDA AVE",
            "address_2": "SPACE #A20",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925448640",
            "telephone_number": "951-765-5544",
            "fax_number": "951-765-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOHEIL KHODADADI DMD, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A",
        "authorized_official_last_name": "KHODADADI",
        "authorized_official_first_name": "SOHEIL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "951-765-5544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1710042478",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hemet Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Hemet, CA
• Providers in Hemet, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.