Individual provider Active NPI

Erika Kohanof

  • General Practice Dentistry
  • Panorama City, CA
National Provider Identifier
1689121519
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100787 Issued in CA
Practice address
14415 Chase St
Panorama City, CA 91402-3017
Phone
(818) 830-9050
NPI assigned
Sep 8, 2016
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 100787 CA Primary

Addresses

Primary practice location

14415 Chase St
Panorama City, CA 91402-3017

Mailing address

14415 Chase St
Panorama City, CA 91402-3017

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
I20170118002137 CA Order and Referring Only - DentistPractitioner - Dentist 8921380460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1689121519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14415 CHASE ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14415 CHASE ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914023017",
            "telephone_number": "818-830-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHANOF",
        "first_name": "ERIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.