Individual provider Active NPI

Khadija Haroon, DDS

  • Dentist
  • Chino Hills, CA
National Provider Identifier
1992557623
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111857 Issued in CA
Practice address
Office 59 - Chino Hills Dental Group
3410 Grand Ave, Ste F
Chino Hills, CA 91709
Phone
(909) 364-0027
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111857 CA Primary

Addresses

Primary practice location

Office 59 - Chino Hills Dental Group
3410 Grand Ave, Ste F
Chino Hills, CA 91709

Mailing address

16301 Butterfield Ranch Road
Unit 8203, Mailbox: 127
Chino Hills, CA 91709-7490
Phone (415) 713-5767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111857CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodgers and Sambangi Dental Corporation PastSince Jul 13, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1992557623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16301 BUTTERFIELD RANCH ROAD",
            "address_2": "UNIT 8203, MAILBOX: 127",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917097490",
            "telephone_number": "415-713-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OFFICE 59 - CHINO HILLS DENTAL GROUP",
            "address_2": "3410 GRAND AVE, STE F",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "91709",
            "telephone_number": "909-364-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROON",
        "first_name": "KHADIJA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.