Njdeh Khodaverdian, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49345 Issued in CA

Practice address

610 N Central Ave
Suite 207
Glendale, CA 91203-1403

Phone

(818) 547-4020

Fax

(818) 547-4026

NPI assigned

Apr 3, 2007

Last updated

Mar 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Njdik Khodaverdian Former name

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

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1912028002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N CENTRAL AVE",
            "address_2": "SUITE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031403",
            "telephone_number": "818-547-4020",
            "fax_number": "818-547-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N CENTRAL AVE",
            "address_2": "SUITE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031403",
            "telephone_number": "818-547-4020",
            "fax_number": "818-547-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAVERDIAN",
        "first_name": "NJDEH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NJDIK",
            "last_name": "KHODAVERDIAN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khemichian MD, Inc
• Leakana Kheng, PHARMD
• Emanouel Khodadadi, MSN-FNP-BC
• Vanessa Khodagholian
• Andrew Khodaverdian, PHARMD
• Khodaverdian,Khachatoorian,DDS,Inc
• Nathaniel Jordan Khoe
• Vigen Khojayan, M.D.
• Choolin Khoo, DDS
• Mehdi Khorsandi, M.D.

• General Practice Dentistry in Glendale, CA
• Providers in Glendale, 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 Mar 29, 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.