Siamak Khakshooy, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

54539 Issued in CA

Practice address

3451 W Century Blvd Ste B1
Inglewood, CA 90303-1228

Phone

(310) 330-9000

NPI assigned

Jan 26, 2007

Sex

Male

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1750437109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 N WETHERLY DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111813",
            "telephone_number": "310-925-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W CENTURY BLVD STE B1",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903031228",
            "telephone_number": "310-330-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAKSHOOY",
        "first_name": "SIAMAK",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Inglewood, CA
• Providers in Inglewood, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.