Suzan Khajavi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61587 Issued in CA

Practice address

4425 S Central Ave
Los Angeles, CA 90011-3629

Phone

(323) 908-4200

NPI assigned

Oct 18, 2012

Sex

Female

Sole proprietor

Yes

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 CA

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

Interoperability endpoints

• Direct secure messaging: suzan.khajavis.p1@direct.scfhc.nextgenshare.com

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1891048500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30909 RUE VALOIS",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902755338",
            "telephone_number": "310-293-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAJAVI",
        "first_name": "SUZAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Negar Khaefi, MFT
• Mana Khafaf, M.D.
• Behnoush Khafajizadeh
• Anadjeet Singh Khahera, MD
• Arkadiy Eric Khaimov
• Amir Saman Khajegi
• Kavita Khajuria, M.D.
• Cindy Khaki
• Mohammad Khaknegar, DDS
• Houman Khakpour, M.D.

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.