NPIMap

Organization Active NPI

Khoshroozeh Dental Corporation

  • Dentist
  • Monrovia, CA
National Provider Identifier
1689023996
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62883 Issued in CA
Legal business name
KHOSHROOZEH DENTAL CORPORATION
Practice address
845 E Foothill Blvd Apt H
Monrovia, CA 91016-2477
Phone
(650) 200-7530
NPI assigned
Jun 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Sara KhoshroozehNPI 1457771149
Title
Doctor
Phone
(650) 200-7530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 62883 CA Primary

Addresses

Primary practice location

845 E Foothill Blvd Apt H
Monrovia, CA 91016-2477

Mailing address

2711 Santa Ana St
South Gate, CA 90280-2021

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1689023996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 SANTA ANA ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 E FOOTHILL BLVD APT H",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162477",
            "telephone_number": "650-200-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHOSHROOZEH DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "KHOSHROOZEH",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "650-200-7530"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "62883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.