Elmira Khodapanah, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43989 Issued in CA

Practice address

2333 Camino del Rio S Ste 140
San Diego, CA 92108-3607

Phone

(619) 574-1810

Fax

(619) 574-1326

NPI assigned

May 9, 2007

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Elmira Khodapanah DDS Inc

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1003120148
  NPD (past) Authorized official
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1942057963
  NPD
• Golden Valley Health Centers

  dba GVHC Pharmacy

  • Community/Retail Pharmacy
  • Merced, CA
  • NPI 1093817405
  NPD

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1750595195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12079 WORLD TRADE DR UNIT 4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284393",
            "telephone_number": "858-485-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 CAMINO DEL RIO S STE 140",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083607",
            "telephone_number": "619-574-1810",
            "fax_number": "619-574-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAPANAH",
        "first_name": "ELMIRA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Khieu, OD
• Vivian Thao Khieu
• Cindy Khine
• Sheetal Khiyani, M.D.
• Swapnil Khoche
• Neda Khodaparast, PSYD
• Jennifer Lin Khoe, M.D.
• Melanie Christine Khoe, NONE
• Tatyana Kholodkov
• Mariya Nikolayevna Kholodova, PH.D.

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, 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 17, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.