Houry Koushakjian, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

45479 Issued in CA

Practice address

4618 Fountain Ave
Los Angeles, CA 90029-1963

Phone

(323) 953-7170

Fax

(323) 663-2379

NPI assigned

Jun 3, 2006

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1104075282
  Medicare reassignment NPD
• Gracelight Community Health

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1013083666
  NPD
• Children's Hospital Los Angeles Mental Health

  dba Children's Hospital LA- QueensCare Health and Faith Partnership

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1518066299
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1972541654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153999",
            "telephone_number": "323-669-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4618 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291963",
            "telephone_number": "323-953-7170",
            "fax_number": "323-663-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUSHAKJIAN",
        "first_name": "HOURY",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kourosh Kevin Daneshgar, M.D., Inc.
• Kourosh Michael Beral DDS Inc
• Kourosh Yousefzadeh DDS
• Matthew Norman Koury, M.D.
• Christina Savalas Kousakis, MFT
• Kousoulis Chiropractic Professional Corporation
• Nicholas D. Kousoulis, D.C.
• Dino Koutsolioutsos
• Jacques Jacques Kouyoumdjian, DDS
• Shaghig Kouyoumjian, M.D.

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.