Niloofar Khosravian

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DDS102381 Issued in CA

Practice address

1920 Corporate Dr
#107 A
San Marcos, TX 78666-6283

Phone

(818) 922-5752

NPI assigned

Jul 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• Jahanbakhsh and Khosravian Dental Partnership

  dba Encino Endodontics

  • Endodontics
  • Encino, CA
  • NPI 1477448884
  NPD Authorized official

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1790126779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041504",
            "telephone_number": "818-922-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 CORPORATE DR",
            "address_2": "#107 A",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666283",
            "telephone_number": "818-922-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVIAN",
        "first_name": "NILOOFAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040753",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31791",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL11947",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057614",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "31791",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "DDS102381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Keup, AUD
• Addison Rose Key
• Hisham Khan
• Jamshaid Aslam Khan, DDS
• Fong Yong Jane Khor, MPT
• Pedram Khosravian, D.M.D.
• Pejman Khosravian, D.M.D
• Ki Charter Academy
• Jadyn Killian, SLPA
• Dawn Nicole Kim-Romo, PHARM.D.

• Endodontics in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.