Individual provider Active NPI

Hether Khosa, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Cincinnati, OH
National Provider Identifier
1972857506
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
30.025966 Issued in OH
Practice address
222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone
(513) 475-8783
Fax
(513) 475-7698
NPI assigned
Nov 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30.025966 OH
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 30.025966 OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Cincinnati, OH 45219-4231

Mailing address

222 Piedmont Ave
Cincinnati, OH 45219-4231
Phone (513) 475-8783

Other identifiers 3

IdentifierTypeStateIssuer
300055609MedicaidIN
0368866MedicaidOH
7100634760MedicaidKY

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200206000576 OH Practitioner - Oral Surgery 3678871043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgical-Dental Associates LLCGroup PAC ID 1658384482, 10 clinicians

Practice addresses (Care Compare)

222 Piedmont Ave
Suite 7300
Cincinnati, OH 45219-4224
Phone (513) 475-8783

Hospital & facility affiliations

  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025966OHMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgical-Dental Associates, LLC Oral and Maxillofacial Surgery CurrentSince Dec 8, 2019 Accepting new patients

Locations

200 Albert Sabin Way
Cincinnati, OH 45267
Phone (513) 475-7500

3805 Edwards Rd
Cincinnati, OH 45209
Phone (513) 321-0833

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

222 Piedmont Ave
Ste 7300
Cincinnati, OH 45219
Phone (513) 475-8783

7690 Discovery Dr
West Chester, OH 45069
Phone (513) 475-7425

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1972857506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452194231",
            "telephone_number": "513-475-8783",
            "fax_number": "513-475-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSA",
        "first_name": "HETHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.025966",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "30.025966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300055609",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0368866",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100634760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.