Heena J Chandra

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

58092 Issued in CA

Practice address

9813 Venice Blvd
Los Angeles, CA 90034-5110

Phone

(323) 371-7918

NPI assigned

May 22, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Heena J Chandra Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 11, 2018 through Oct 11, 2026

Medicare enrollment (NPD)

Enrolled

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.

• Costa Mesa Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Costa Mesa, CA
  • NPI 1598347510
  NPD (past)

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

{
    "created_epoch": "1274486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1700105384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9813 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345110",
            "telephone_number": "323-371-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9813 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345110",
            "telephone_number": "323-371-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRA",
        "first_name": "HEENA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-22",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "58092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEENA",
            "last_name": "CHANDRA",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "D.D.S, MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robert Wells Chandler, M.D.
• Ryan Chandler, LPCC, LCMHC, MLADC
• Sonja Ann Chandler, PT
• Tara Zabren Chandler, LCSW
• Stebbins Chandor, M.D.
• Jesslyn Chrestella Chandra
• Ambika Chandramohan
• Gangadarshni Chandramohan, M.D.
• Brindha Chandran
• Inggrid Chandranata, ND

• Oral and Maxillofacial Surgery (Dentist) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.