Individual provider Active NPI

Julia Faye Khatibzadeh, DDS

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1558931725
Registry record updated Jul 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12328 Issued in NC
Practice address
811 9TH St Ste 280
Durham, NC 27705-4149
Phone
(919) 286-9090
NPI assigned
Jun 29, 2021
Last updated
Jul 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12328 NC
General Practice Dentistry 1223G0001X 12328 NC Primary

Addresses

Primary practice location

811 9TH St Ste 280
Durham, NC 27705-4149

Mailing address

64 Zephyr Dr
Chapel Hill, NC 27517-9560
Phone (908) 310-6774

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
12328NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688256000000",
    "number": "1558931725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 ZEPHYR DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275179560",
            "telephone_number": "908-310-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 9TH ST STE 280",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054149",
            "telephone_number": "919-286-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIBZADEH",
        "first_name": "JULIA",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-07-02",
        "certification_date": "2023-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12328",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2023; 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.