Individual provider Active NPI

Michelle Khouri, DDS

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1811411713
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
101718 Issued in CA
Practice address
750 N Capitol Ave
San Jose, CA 95133-1913
Phone
(408) 258-5054
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 101718 CA Primary

Addresses

Primary practice location

750 N Capitol Ave
San Jose, CA 95133-1913

Mailing address

5925 Foligno Way
San Jose, CA 95138-2226
Phone (408) 506-5083

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

LicenseStateTypeSpecialty
101718CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Khouri Dental Group General Practice CurrentSince Aug 18, 2024 Accepting new patients

Locations

750 N Capitol Ave
Ste A2
San Jose, CA 95133
Phone (408) 258-5054

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1811411713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 FOLIGNO WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382226",
            "telephone_number": "14085065083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N CAPITOL AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951331913",
            "telephone_number": "408-258-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURI",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.