Organization Active NPI

Mohd Khalaf DDS Inc

  • Orofacial Pain Dentistry
  • Roseville, CA
National Provider Identifier
1962266296
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
Legal business name
MOHD KHALAF DDS INC
Practice address
2520 Douglas Blvd Ste 140
Roseville, CA 95661-3993
Phone
(916) 860-1661
NPI assigned
Feb 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Dr. Mohd Khalaf, DDSNPI 1316251242
Title
Owner
Phone
(859) 539-3427

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X2210X Primary
Multi-Specialty Clinic/Center 261QM1300X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

2520 Douglas Blvd Ste 140
Roseville, CA 95661-3993

Mailing address

2520 Douglas Blvd Ste 140
Roseville, CA 95661-3993
Phone (916) 860-1661

Other names 1

  • The Head Pain Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240429001708 CA Part B Supplier - Clinic/Group Practice 9436599131 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, CA

National Provider Directory

National Provider Directory

Locations

2520 Douglas Blvd
Ste 140
Roseville, CA 95661
Phone (859) 539-3427

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1962266296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 DOUGLAS BLVD STE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613993",
            "telephone_number": "916-860-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 DOUGLAS BLVD STE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613993",
            "telephone_number": "916-860-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHD KHALAF DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "KHALAF",
        "authorized_official_first_name": "MOHD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-539-3427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Head Pain Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Head Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.