Individual provider Active NPI

Poriya Dokhanchi, DDS

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1417003740
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
94060 Issued in CA
Practice address
2001 Union St
#690
San Francisco, CA 94123-4114
Phone
(415) 921-9210
NPI assigned
Jan 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 94060 CA Primary

Addresses

Primary practice location

2001 Union St
#690
San Francisco, CA 94123-4114

Mailing address

2001 Union St
#690
San Francisco, CA 94123-4114
Phone (415) 921-9210

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150714000672 CA Order and Referring Only - DentistPractitioner - Dentist 2163735648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46050CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
M.Jamali DMD, P.Dokhanchi DDS, Apc General Practice Past Accepting new patients
Poriya Dokhanchi, DDS, Apc General Practice Past Accepting new patients

Organizations & group practices 2

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": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417003740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 UNION ST",
            "address_2": "#690",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234114",
            "telephone_number": "415-921-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 UNION ST",
            "address_2": "#690",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941234114",
            "telephone_number": "415-921-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKHANCHI",
        "first_name": "PORIYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "94060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.