Individual provider Active NPI

Ridila Khan, DDS

  • Pediatric Dentistry
  • Fresno, CA
National Provider Identifier
1730882457
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
111144 Issued in CA
Practice address
7525 N Cedar Ave Ste 105
Fresno, CA 93720-2698
Phone
(559) 439-6600
NPI assigned
Mar 22, 2023
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901601601 MI
Pediatric Dentistry 1223P0221X 111144 CA Primary

Addresses

Primary practice location

7525 N Cedar Ave Ste 105
Fresno, CA 93720-2698

Mailing address

21 W Barcelona LN
Clovis, CA 93619-2601
Phone (559) 708-2587

Other practice location 1

806 Tuuri Pl
Flint, MI 48503-2465
Phone (810) 767-5750

Other practice location 2

7766 N Palm Ave Ste 104
Fresno, CA 93711-5704
Phone (559) 492-8098

Other practice location 3

1168 Olivewood Dr
Merced, CA 95348-1210
Phone (209) 934-3200

Other practice location 4

1900 Shaw Ave Ste 101
Clovis, CA 93611-4209
Phone (559) 439-5300

Other names 1

  • Ridila Rabbi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901601601MIMDDentist
111144CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
California Kidds Pediatric Dentistry, a Dental Practice of Evans, Kunk Pediatric Dentistry PastSince May 16, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rkhan91554@valleychildrens-prd.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1730882457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W BARCELONA LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936192601",
            "telephone_number": "559-708-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 N CEDAR AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202698",
            "telephone_number": "559-439-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "806 Tuuri Pl",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485032465",
            "country_code": "US",
            "telephone_number": "810-767-5750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7766 N Palm Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937115704",
            "country_code": "US",
            "telephone_number": "559-492-8098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1168 Olivewood Dr",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953481210",
            "country_code": "US",
            "telephone_number": "209-934-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Shaw Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936114209",
            "country_code": "US",
            "telephone_number": "559-439-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RIDILA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601601",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "111144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RIDILA",
            "last_name": "RABBI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.