Organization Active NPI

Khavis LLC

Doing business as Dream Dental

  • Dental Clinic/Center
  • Lyndhurst, OH
National Provider Identifier
1861102329
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KHAVIS LLC
Doing business as
Dream Dental
Practice address
5596 Mayfield Rd
Lyndhurst, OH 44124-2921
Phone
(440) 442-8220
NPI assigned
Nov 24, 2022
Last updated
Nov 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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

Authorized official

Name
Rafael Khavis, DDSNPI 1578175089
Title
Statutory Agent/Dentist
Phone
(917) 822-4185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

5596 Mayfield Rd
Lyndhurst, OH 44124-2921

Mailing address

4499 Groveland Rd
University Heights, OH 44118-3920

Other names 1

  • Dream Dental Doing business as

National Provider Directory

National Provider Directory

Locations

5596 Mayfield Rd
Lyndhurst, OH 44124
Phone (440) 442-8220

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1669248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669248000000",
    "number": "1861102329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 GROVELAND RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5596 MAYFIELD RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242921",
            "telephone_number": "440-442-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHAVIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-24",
        "last_updated": "2022-11-24",
        "certification_date": "2022-11-24",
        "status": "A",
        "authorized_official_last_name": "KHAVIS",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "STATUTORY AGENT/DENTIST",
        "authorized_official_telephone_number": "917-822-4185",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2022; 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.