Khansa Khusro, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS111020 Issued in CA

Practice address

23130 Lyons Ave
Newhall, CA 91321-2631

Phone

(661) 219-0001

NPI assigned

Jul 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1780420059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 CLARKIA ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650213",
            "telephone_number": "805-667-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23130 LYONS AVE",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212631",
            "telephone_number": "661-219-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUSRO",
        "first_name": "KHANSA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602297",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS111020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmin Khachatryan
• Chand Khanna, M.D.
• Veronika Khasanova, BT
• Thuy Trang Thi Khong, PHARMD
• Kajik Khudabakhshyan
• Nancy Garrett King, LMFT
• Walter Harold King, MFT
• KM Speech and Language Pathology, Inc.
• Robert J Kogen, DDS
• Courtney Kosnik

• General Practice Dentistry in Newhall, CA
• Providers in Newhall, 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 Feb 11, 2025; 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.