Active NPI
Katy Chahine, DDS
- Periodontics
- Los Angeles, CA
National Provider Identifier
1356533541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 59222
- Practice address
- 12055 Goshen Ave
Los Angeles, CA 90049-6309 - Phone
- (519) 562-5471
- NPI assigned
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901019187 | MI | |
| Periodontics | 1223P0300X | 59222 | CA | Primary |
Addresses
Primary practice location
12055 Goshen Ave
Los Angeles, CA 90049-6309
Mailing address
12055 Goshen Ave
Los Angeles, CA 90049-6309
Phone (519) 562-5471
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170601000401 | CA | Order and Referring Only - Other (Physician) | 6305113010 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019187 | MI | MD | Periodontist |
| 59222 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1356533541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12055 GOSHEN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496309",
"telephone_number": "519-562-5471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12055 GOSHEN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900496309",
"telephone_number": "519-562-5471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAHINE",
"first_name": "KATY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-13",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "2901019187",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "59222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.