Provider Type Icon

DR. MOHAMMAD AMIN KHOSHNEVISAN DMD NPI 1114308855


NPI Information

NPI: 1114308855
Provider Name: DR. MOHAMMAD AMIN KHOSHNEVISAN, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
630 W 168TH ST RM 250
NEW YORK, NY
ZIP 10032
Phone: (212) 342-0424
Get Directions

DR. Mohammad Amin Khoshnevisan, DMD is an oral and maxillofacial surgery dentist in New York, NY with 9 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Mohammad Amin Khoshnevisan, DMD NPI is 1114308855. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduation Year:2015

The provider's business location address is:

630 W 168TH ST RM 250
NEW YORK, NY
ZIP 10032-725
Phone: (212) 342-0424
Fax: (212) 305-9017

The NPI 1114308855 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/17/2015 and was last updated on 8/1/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist30.026201OHIONo
2122300000XDentistDS042004PENNSYLVANIANo
31223S0112XDentistOral and Maxillofacial Surgery018001949ILLINOISNo
41223S0112XDentistOral and Maxillofacial Surgery062474NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.