Active NPI
Kasra Khamooshi
- Dentist
- Potomac, MD
National Provider Identifier
1760036891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17095
- Practice address
- 10000 Falls Rd Ste 301
Potomac, MD 20854-4103 - Phone
- (301) 983-2165
- NPI assigned
- Jul 26, 2019
- Last updated
- Nov 24, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN24564 | FL | |
| Dentist | 122300000X | 0401416647 | VA | |
| Dentist | 122300000X | 17095 | MD | Primary |
Addresses
Primary practice location
10000 Falls Rd Ste 301
Potomac, MD 20854-4103
Mailing address
1844 Foxstone Dr
Vienna, VA 22182-2131
Phone (571) 296-6419
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN24564 | FL | MD | Dentist |
| 17095 | MD | MD | Dentist |
| 0401416647 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anita Kianimanesh D.M.D, Inc | Dentist | Past | Accepting new patients |
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.
-
- Dentist
- Falls Church, VA
- NPI 1184063547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1760036891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1844 FOXSTONE DR",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822131",
"telephone_number": "571-296-6419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 FALLS RD STE 301",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208544103",
"telephone_number": "301-983-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAMOOSHI",
"first_name": "KASRA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-26",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN24564",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401416647",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "17095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potomac, MD
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- Kevin Schwarz Therapy, LLC (Maryland Mental Health Counseling)
- Irfan Ahmad Khan, PHARM.D.
- Savan Nand Khanna, PHARMD
- Hanieh Khorshidi, BSN, AGNP-BC
- Kid's Neuro
- Hae Jin Kim, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.