Organization Active NPI

Emmanuel Kandkhorov, D.D.S., Inc.

Doing business as MMSI Dental Center

  • Dentist
  • Irvine, CA
National Provider Identifier
1376825794
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50617 Issued in CA
Legal business name
EMMANUEL KANDKHOROV, D.D.S., INC.
Doing business as
MMSI Dental Center
Practice address
33 Creek Rd Ste a-150
Irvine, CA 92604-4791
Phone
(949) 825-7799
NPI assigned
Sep 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Emmanuel Kandkhorov, D.D.S.
Title
President
Phone
(949) 825-7799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 50617 CA Primary

Addresses

Primary practice location

33 Creek Rd Ste a-150
Irvine, CA 92604-4791

Mailing address

33 Creek Rd Ste a-150
Irvine, CA 92604-4791
Phone (949) 825-7799

Other names 1

  • MMSI Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

33 Creek Rd
Ste A150
Irvine, CA 92604
Phone (949) 825-7799

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1376825794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CREEK RD STE A-150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044791",
            "telephone_number": "949-825-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CREEK RD STE A-150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044791",
            "telephone_number": "949-825-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL KANDKHOROV, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "KANDKHOROV",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-825-7799",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMSI Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.