Hamid Cohen Kheradyar, DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HAMID COHEN KHERADYAR, DDS, INC.

Practice address

138 S Gaffey St
San Pedro, CA 90731-2430

Phone

(310) 514-9100

Fax

(310) 514-9119

NPI assigned

Jul 10, 2007

Organization subpart

No

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

Authorized official

Name

Hamid Cohen Kheradyar, DDSNPI 1851469985

Title

Owner

Phone

(310) 514-9100

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hamid Cohen Kheradyar, DDS

  • General Practice Dentistry
  • San Pedro, CA
  • NPI 1851469985

  CA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1891993036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312430",
            "telephone_number": "310-514-9100",
            "fax_number": "310-514-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S GAFFEY ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312430",
            "telephone_number": "310-514-9100",
            "fax_number": "310-514-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMID COHEN KHERADYAR, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "KHERADYAR",
        "authorized_official_first_name": "HAMID",
        "authorized_official_middle_name": "COHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-514-9100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "39023",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERIODONTIST",
            "identifier": "444495",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G89860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawki Haffar, M.D.
• Shaghayegh Haghighat, M.D.
• Andrew Jan Hajduczek, M.D.
• Sharon Andrea Haley, B.A.
• Manuel Rafael Halfon, MBA
• Jeanette Hamming
• Nina M Hamouni, BA
• Susan Leigh Hana Bump
• Hanaa Hanna, MD., Inc.
• Carol Tomiye Hanaki, LPT

• All providers in San Pedro, CA
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.