Active NPI
Shadi Khoshbin, DDS
- General Practice Dentistry
- Granada Hills, CA
National Provider Identifier
1306289814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40953
- Practice address
- 17656 Chastworth St.
Granada Hills, CA 91344 - Phone
- (818) 363-0200
- Fax
- (818) 363-2167
- NPI assigned
- Apr 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40953 | CA | Primary |
Addresses
Primary practice location
17656 Chastworth St.
Granada Hills, CA 91344
Mailing address
17656 Chastworth St.
Granada Hills, CA 91344
Phone (818) 363-0200
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40953 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365984000000",
"number": "1306289814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17656 CHASTWORTH ST.",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "91344",
"telephone_number": "818-363-0200",
"fax_number": "818-363-2167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17656 CHASTWORTH ST.",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "91344",
"telephone_number": "818-363-0200",
"fax_number": "818-363-2167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOSHBIN",
"first_name": "SHADI",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-15",
"last_updated": "2013-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "40953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granada Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.