Khaled Eissa, BDS

Primary specialty

DentistTaxonomy code 122300000X

License

59237 Issued in CA

Practice address

1935 Dainty Way
Hemet, CA 92545-8960

Phone

(763) 587-8345

NPI assigned

Jan 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: keissa@direct.westerndental.com

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

• Daoud and Eissa Dental Inc.

  dba Delmar Dental

  • Dentist
  • Vista, CA
  • NPI 1275068108
  Authorized official Same address or phone
• Khaled Eissa DDS Inc

  • Dentist
  • Lake Elsinore, CA
  • NPI 1952745895
  NPD (past) Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1407903776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 DAINTY WAY",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925458960",
            "telephone_number": "763-587-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 DAINTY WAY",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925458960",
            "telephone_number": "763-587-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISSA",
        "first_name": "KHALED",
        "credential": "BDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12352",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edge Medical Services
• Edward J Formica D.D.S., Inc. (Formica Family Dental Practice Edward J Formica DDS, Inc.)
• Tanasha Edwards
• Benson Eghreriniovo, MD
• Curtis J Eirew, RPH
• Iglal El Henawi, MD
• El Norte Pharmacy (A Family Pharmacy Hemet)
• Torri Elder
• Abanob A Elias, MD
• Lisa Dawn Elkins, CADC1

• Dentist in Hemet, CA
• Providers in Hemet, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.