Kasra Tajik, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63665 Issued in CA

Practice address

10545 Victory Blvd
North Hollywood, CA 91606-3916

Phone

(818) 763-9353

Fax

(818) 763-6227

NPI assigned

Aug 6, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tajik Naminik & Koshki DDS Inc

  • General Practice Dentistry
  • North Hollywood, CA
  • NPI 1710332838
  NPD (past) Authorized official

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1386053171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10545 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063916",
            "telephone_number": "818-763-9353",
            "fax_number": "818-763-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10545 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063916",
            "telephone_number": "818-763-9353",
            "fax_number": "818-763-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJIK",
        "first_name": "KASRA",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farzaneh Tabibian, RN
• Carolina Tadevosyan, FNP
• Gevorg Tadevosyan
• Nadia E Taheri, DMD
• Tajik Naminik & Koshki DDS Inc
• Mojgan Tamaddon, D.D.S.
• Aliza Gail Tan
• Joshua Zachary Tan
• Pauline Tan, MPH
• Boonsita Tangsopon

• General Practice Dentistry in North Hollywood, CA
• Providers in North Hollywood, 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 Sep 28, 2016; 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.

Verify at the official NPI Registry.