Individual provider Active NPI

Khawla Aljohani, DDS

  • Periodontics
  • Medina, OH
National Provider Identifier
1528514536
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30.026369 Issued in OH
Practice address
750 E Washington St Ste B2
Medina, OH 44256-2137
Phone
(330) 725-6151
NPI assigned
Aug 30, 2016
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 30.026369 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X RES.3771 OH

Addresses

Primary practice location

750 E Washington St Ste B2
Medina, OH 44256-2137

Mailing address

750 E Washington St Ste B2
Medina, OH 44256-2137
Phone (330) 725-6151

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

LicenseStateTypeSpecialty
30.026369OHMDPeriodontist
RES.3771OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kay's Periodontics and Implant Dentistry Periodontics Current Accepting new patients
Periodontal Associates, Inc. Periodontics PastSince Sep 1, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1528514536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E WASHINGTON ST STE B2",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562137",
            "telephone_number": "330-725-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E WASHINGTON ST STE B2",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562137",
            "telephone_number": "330-725-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALJOHANI",
        "first_name": "KHAWLA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30.026369",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "RES.3771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.