Khashayar Khodadadi Dds Inc - Medicare Dental Clinic in Los Angeles, CA

Khashayar Khodadadi Dds Inc is a medicare enrolled dental clinic (Dentist - General Practice) in Los Angeles, California. The current practice location for Khashayar Khodadadi Dds Inc is 11900 S. Avalon Blvd., Suite 101, Los Angeles, California. For appointments, you can reach them via phone at (323) 834-0100. The mailing address for Khashayar Khodadadi Dds Inc is 11900 S. Avalon Blvd., Suite 101, Los Angeles, California and phone number is (323) 834-0100.

Khashayar Khodadadi Dds Inc is licensed to practice in California (license number 43026). The clinic also participates in the medicare program and its NPI number is 1003033556. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (323) 834-0100.

Contact Information

Khashayar Khodadadi Dds Inc
11900 S. Avalon Blvd.
Suite 101
Los Angeles
CA 90061
(323) 834-0100
(323) 834-0101

Dental Care Clinic Profile

Full NameKhashayar Khodadadi Dds Inc
SpecialityDentist
Location11900 S. Avalon Blvd., Los Angeles, California
Authorized Official Name and PositionKhashayar Khodadadi (PRESIDENT)
Authorized Official Contact3238340100
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Khashayar Khodadadi Dds Inc
11900 S. Avalon Blvd.
Suite 101
Los Angeles
CA 90061

Ph: (323) 834-0100
Khashayar Khodadadi Dds Inc
11900 S. Avalon Blvd.
Suite 101
Los Angeles
CA 90061

Ph: (323) 834-0100

NPI Details:

NPI Number1003033556
Provider Enumeration Date04/19/2007
Last Update Date06/14/2010

Medicare PECOS Information:

Medicare PECOS PAC ID2668785346
Medicare Enrollment IDO20150723009523

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Medical Identifiers

Medical identifiers for Khashayar Khodadadi Dds Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003033556NPI-NPPES
G93919-01OtherCADENTI-CAL PROVIDER NUMBER

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice 43026 (California)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Khashayar Khodadadi Dds Inc acts as a billing entity for following providers:
Provider NameKhashayar Khodadadi
Provider TypePractitioner - Oral Surgery
Provider IdentifiersNPI Number: 1083743926
PECOS PAC ID: 6507180759
Enrollment ID: I20150617002165

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