Individual provider Active NPI

Raghav Khandelwal, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Walnut Creek, CA
National Provider Identifier
1871970947
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
63762 Issued in CA
Practice address
1855 San Miguel Dr Ste 25
Walnut Creek, CA 94596-5298
Phone
(510) 437-4800
NPI assigned
Apr 28, 2015
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 63762 CA Primary

Addresses

Primary practice location

1855 San Miguel Dr Ste 25
Walnut Creek, CA 94596-5298

Mailing address

70101 Via Vicenza
San Ramon, CA 94583-3132
Phone (562) 650-7618

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
63762CAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1871970947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70101 VIA VICENZA",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833132",
            "telephone_number": "562-650-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SAN MIGUEL DR STE 25",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965298",
            "telephone_number": "510-437-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDELWAL",
        "first_name": "RAGHAV",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-28",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "63762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.