Daniel Khodorkovsky, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

062684-01 Issued in NY

Practice address

30 E 60TH St Ste 608
New York, NY 10022-1038

Phone

(347) 566-0219

NPI assigned

May 1, 2020

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Smile House Dental P.C.

  • Dentist
  • Corona, NY
  • NPI 1780403444
  NPD Authorized official

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1740801679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD PALISADE RD APT 3711",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST STE 608",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221038",
            "telephone_number": "347-566-0219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODORKOVSKY",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-01",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062684-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Khodadadian, M.D.
• Gohar Khodadoost, DMD
• Kiana Khodadoostan Shahraki, DDS
• Iman Khodarahmi, MD
• Valeriya Khodatovych
• Nika Khodorkovsky, CCC-SLP
• Leonid Khodorovskiy, PHARM. D.
• Alla Khodzhayeva, RPH
• Ahmed Khokhar
• Dharti Pravin Khokhar

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.