Melody Khonsari

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

103107 Issued in CA

Practice address

1760 E Avenida de Los Arboles Ste a
Thousand Oaks, CA 91362-1392

Phone

(805) 494-5255

NPI assigned

Sep 23, 2018

Last updated

Sep 23, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537660800000",
    "number": "1720562978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 RUNNYMEDE ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062844",
            "telephone_number": "818-668-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E AVENIDA DE LOS ARBOLES STE A",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913621392",
            "telephone_number": "805-494-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHONSARI",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-23",
        "last_updated": "2018-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2018; 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.