Nasim Khoshfetrat, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019031302 Issued in IL

Practice address

2500 W North Ave
Chicago, IL 60647-5202

Phone

(773) 360-1281

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1689167983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475202",
            "telephone_number": "773-360-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHFETRAT",
        "first_name": "NASIM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazel Khosa, MBBS
• Audisho Brimo Khoshaba, M.D.
• Edena Khoshaba
• Margaret Hensley Khoshaba
• Sargiss Khoshaba
• Reza J Khoshnood, D.M.D.
• Ishan Khosla, MD
• Kavia Khosla, MD
• Neenoo Khosla, MD
• Paramjeet G Khosla, M.D.

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.