DR. ARDAVAN R. KHERADPIR (NPI# 1053417261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053417261 |
| Entity Type | Individual |
| Full Name | DR. ARDAVAN R. KHERADPIR |
| Credential | D.M.D. |
| Practice Address |
3812 N 1st St Fresno CA 93726-4301 |
| Mailing Address |
7025 N Maple Ave Ste 108 Fresno CA 93720-8006 |
| Practice Telephone | 5592262722 |
| Practice Fax Number | 5592266989 |
| Mailing Telephone | 5592262722 |
| Mailing Fax Number | 5592266989 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2016-08-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 52875 | CA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
52875 | CA | Dental Providers |
| Street Address |
3812 N 1ST ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93726-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396721197 | Omni Womens Health Medical Group Inc | Obstetrics & Gynecology | 3812 N 1st St, Fresno, CA 93726-4301 | 2005-12-22 |
| 1801280433 | Evanglyn Soyland | Nurse Practitioner | 3812 N 1st St, Fresno, CA 93726-4301 | 2015-03-20 |
| 1205241528 | Silvia Echeveste | Nurse Practitioner | 3812 N 1st St, Fresno, CA 93726-4301 | 2014-06-25 |
| 1952670606 | Amanda Vlasveld | Physician Assistant | 3812 N 1st St, Fresno, CA 93726-4301 | 2011-12-27 |
| 1932331527 | Erica Lynn Bedsted | Nurse Practitioner | 3812 N 1st St, Fresno, CA 93726-4301 | 2009-08-14 |
| 1811161193 | Priscilla Rodriguez | Physician Assistant | 3812 N 1st St, Fresno, CA 93726-4301 | 2008-04-17 |
| 1891997813 | Omni Women's Health Medical Group, Inc | Clinical Medical Laboratory | 3812 N 1st St, Fresno, CA 93726-4301 | 2007-06-01 |
| 1366569238 | Evelyn Logan | Nurse Practitioner | 3812 N 1st St, Fresno, CA 93726-4301 | 2007-03-23 |
| 1114905205 | Deborah Jo Mcbride | Nurse Practitioner | 3812 N 1st St, Fresno, CA 93726-4301 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520814 | Tania Grijalva Miranda | Behavior Technician | 4910 E. Ashland Ave, Fresno, CA 93726 | 2019-04-04 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1013481100 | Jill A Perricone | Respiratory Therapist, Registered | 4785 N First St, Fresno, CA 93726 | 2019-01-11 |
| 1285108399 | Leann Lokelani Benton | Respiratory Therapist, Registered | 4785 N. First St, Fresno, CA 93726 | 2019-01-11 |
| 1548745912 | Alina Gonzalez | Counselor | 4440 N. First St., Fresno, CA 93726 | 2018-10-01 |
| 1336622067 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 3751 E Shields Ave, Fresno, CA 93726 | 2018-09-10 |
| 1730676206 | Joanne K Groves | Counselor | 3636 N. First Street, St. 123, Fresno, CA 93726 | 2018-04-19 |
| 1356865679 | Fresno Mental Psychological Health Services, P.C. | Clinic/Center | 4021 N Fresno Street, Ste. 101, Fresno, CA 93726 | 2017-07-28 |
| 1205358819 | Jetinder Singh Ghag | Counselor | 3636 N.first St # 135 and 154, Fresno, CA 93726 | 2017-07-14 |
| 1164897328 | Karam Um Dds Inc | Dentist | 4747 N. First St. #174, Fresno, CA 93726 | 2015-12-14 |
| Find all providers in zip 93726 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| 1306212428 | Robin Lynn Reisz | Dentist | 1105 E Spruce Ave Ste 204, Fresno, CA 93720-3313 | 2015-08-12 |
| 1396155875 | Phillip Austin Harrison | Dentist | 1195 W San Ramon Ave, Fresno, CA 93711-3152 | 2014-05-05 |
| 1417390253 | Brian K Huh | Dentist | 1903 E Fir Ave Ste 101, Fresno, CA 93720-3862 | 2013-04-11 |
| 1164688396 | Shabaz Sandhu | Dentist | 498 W Bluff Ave, Fresno, CA 93711-6928 | 2008-08-07 |
| 1962699777 | Scott J. Fimbres, D.d.s., Inc. | Dentist | 7585 N Colonial Ave Ste 105, Fresno, CA 93711 | 2007-09-26 |
| 1952528671 | Jason Sorensen D.d.s. A Professional Corporation | Dentist | 1480 W Herndon Ave, Fresno, CA 93711-0552 | 2007-04-20 |
| 1508938523 | Center for Corrective Jaw & Facial Surgery .... | Dentist | 7055 N Fresno St #202, Fresno, CA 93720 | 2006-11-14 |
| 1831282755 | David Russell Adams | Dentist | 1111 E Herndon Ave Ste 119, Fresno, CA 93720-3100 | 2006-10-02 |
| 1144257619 | Gerald Wayne Alexander | Dentist | 7585 N Colonial Ave, Ste 105, Fresno, CA 93711-5889 | 2006-06-28 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.