Active NPI
Kimya Khodamardi, DMD
- Dentist
- Davis, CA
National Provider Identifier
1427751650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS109818
- Practice address
- 2051 John Jones Rd
Davis, CA 95616-9701 - Phone
- (866) 268-4489
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS109818 | CA | Primary |
Addresses
Primary practice location
2051 John Jones Rd
Davis, CA 95616-9701
Mailing address
901 Sunvalley Blvd Ste 110
Concord, CA 94520-5816
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS109818 | CA | MD | Dentist |
Interoperability endpoints
- kkhodamardi725321@direct.ochin.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1427751650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 SUNVALLEY BLVD STE 110",
"city": "CONCORD",
"state": "CA",
"postal_code": "945205816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 JOHN JONES RD",
"city": "DAVIS",
"state": "CA",
"postal_code": "956169701",
"telephone_number": "866-268-4489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHODAMARDI",
"first_name": "KIMYA",
"name_prefix": "Ms.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS109818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.