Individual provider Active NPI

Rimma Khamish, D.D.S.

  • Dentist
  • San Rafael, CA
National Provider Identifier
1376788869
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50148 Issued in CA
Practice address
11 Greenfield Ave
San Rafael, CA 94901-2661
Phone
(415) 460-2106
Fax
(415) 453-7506
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50148 CA Primary

Addresses

Primary practice location

11 Greenfield Ave
San Rafael, CA 94901-2661

Mailing address

11 Greenfield Ave
San Rafael, CA 94901-2661
Phone (415) 460-2106

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50148CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1376788869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GREENFIELD AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012661",
            "telephone_number": "415-460-2106",
            "fax_number": "415-453-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GREENFIELD AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012661",
            "telephone_number": "415-460-2106",
            "fax_number": "415-453-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMISH",
        "first_name": "RIMMA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.