Khamida A Badalova, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS041409 Issued in PA

Practice address

2459 Aramingo Ave
Philadelphia, PA 19125-3731

Phone

(215) 427-2800

NPI assigned

Jun 26, 2017

Last updated

Jun 26, 2017By the provider in NPPES

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 PA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pro Dental Group PC

  • Dentist
  • Levittown, PA
  • NPI 1851089841
  NPD Authorized official
• Dental Dreams, LLC

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1972732428
  NPD (past)

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1851811319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2459 ARAMINGO AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253731",
            "telephone_number": "215-427-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADALOVA",
        "first_name": "KHAMIDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Backstrom, DPT
• Derrick Bacon
• Karey Anna Bacon, PMHNP, BSN, RN
• Nadara Disha Bacon
• Zayionah Bacon, RBT
• Anaida Badalyan
• Diana Badalyan
• Avni Umesh Badami
• Sara Susanabigail Badaracco, M.A.
• Meredith Ashley Badawi, PA-C

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.