Individual provider Active NPI

Kaveh Kohanof, DDS

  • Dentist
  • Mission Hills, CA
National Provider Identifier
1669787701
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59573 Issued in CA
Practice address
15300 Devonshire St
Suite #6
Mission Hills, CA 91345-2781
Phone
(818) 894-6411
NPI assigned
Aug 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59573 CA Primary

Addresses

Primary practice location

15300 Devonshire St
Suite #6
Mission Hills, CA 91345-2781

Mailing address

5485 Cahill Ave
Tarzana, CA 91356
Phone (818) 605-7917

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200327001633 CA Practitioner - Oral Surgery 1557790458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59573CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kohanof and Zarabian DDS Dental Corp Dentist CurrentSince Feb 9, 2020 Accepting new patients
Koahnof and Zarabian DDS Dental Corp Dentist Current Accepting new patients

Locations

15534 Devonshire St
Unit 108
Mission Hills, CA 91345
Phone (818) 894-6411

15300 Devonshire St
Ste 6
Mission Hills, CA 91345
Phone (818) 894-6411

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1669787701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5485 CAHILL AVE",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "91356",
            "telephone_number": "818-605-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 DEVONSHIRE ST",
            "address_2": "SUITE #6",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913452781",
            "telephone_number": "818-894-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHANOF",
        "first_name": "KAVEH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.