Noor Al-Khatib, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

108137 Issued in CA

Practice address

21750 Valley Blvd Ste C
City of Industry, CA 91789-0939

Phone

(909) 595-0807

NPI assigned

Sep 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pandhoh Dental Corporation

  • General Practice Dentistry
  • City of Industry, CA
  • NPI 1184887382

  General Practice

  NPD (past)
• Watanabe and to Dental Corporation

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1326143256

  General Practice

  NPD (past)

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1578286589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21750 VALLEY BLVD STE C",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917890939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21750 VALLEY BLVD STE C",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917890939",
            "telephone_number": "909-595-0807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10286 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925035357",
            "country_code": "US",
            "telephone_number": "951-359-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-KHATIB",
        "first_name": "NOOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108137",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "108137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Andres Aguilar
• Destiny Lee Aguirre, LMFT
• Ryan James Aguirre
• Michelle Esteban Agustin
• Neda Ahmed
• Sarah Aladross
• Lizette Alarcon
• Aniesa Alba
• Mariella Alcala
• Keila Alejandre

• General Practice Dentistry in City of Industry, CA
• Providers in City of Industry, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.