Individual provider Active NPI

Ashoo Khanuja, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Independence, OH
National Provider Identifier
1396885851
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
35076890K Issued in OH
Practice address
6701 Rockside Rd
Suite #209
Independence, OH 44131-2358
Phone
(216) 328-1234
Fax
(216) 328-1229
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21566 OH
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 35076890K OH Primary

Addresses

Primary practice location

6701 Rockside Rd
Suite #209
Independence, OH 44131-2358

Mailing address

6701 Rockside Rd
Suite #209
Independence, OH 44131-2358
Phone (216) 328-1234

Other identifiers 1

IdentifierTypeStateIssuer
23321400MedicaidOH

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21566OHMDDentist
35076890KOHMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Ashoo Khanuja, DDS, MD Oral and Maxillofacial Surgery CurrentSince Sep 1, 2001 Accepting new patients

Locations

6701 Rockside Rd
Ste 209
Independence, OH 44131
Phone (216) 328-1234

Interoperability endpoints

  • Direct secure messaging: akhanuja35960@ehrdirect.uhhospitals.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1396885851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "SUITE #209",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-328-1234",
            "fax_number": "216-328-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "SUITE #209",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-328-1234",
            "fax_number": "216-328-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANUJA",
        "first_name": "ASHOO",
        "credential": "DDS MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "21566",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "35076890K",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23321400",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.