Active NPI
Parivash Khajavi, DMD
- Dentist
- Buriem, WA
National Provider Identifier
1437287364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7998
- Practice address
- 14212 Ambaum Blvd
SW #305
Buriem, WA 98166 - Phone
- (206) 988-3968
- Fax
- (206) 988-3969
- NPI assigned
- Mar 1, 2007
- Last updated
- Dec 17, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 7998 | WA | Primary |
Addresses
Primary practice location
14212 Ambaum Blvd
SW #305
Buriem, WA 98166
Mailing address
14212 Ambaum Blvd SW Ste 305
Burien, WA 98166-1437
Phone (206) 988-3968
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 911886 | Other | WA | UNITED CONCORDIA |
| 5037023 | Medicaid | WA |
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 |
|---|---|---|---|
| 7998 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639699200000",
"number": "1437287364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14212 AMBAUM BLVD SW STE 305",
"city": "BURIEN",
"state": "WA",
"postal_code": "981661437",
"telephone_number": "206-988-3968",
"fax_number": "206-988-3969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14212 AMBAUM BLVD",
"address_2": "SW #305",
"city": "BURIEM",
"state": "WA",
"postal_code": "98166",
"telephone_number": "206-988-3968",
"fax_number": "206-988-3969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAJAVI",
"first_name": "PARIVASH",
"name_prefix": "Mrs.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2021-12-17",
"certification_date": "2021-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "7998",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "911886",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5037023",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.