Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1013085281 Deactivated / Inactive NPI Male Practitioner

Mohammad Khadiv

Dentist - General Practice • Wilmington, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mohammad Khadiv has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 04, 2006
NPI Deactivation Date December 17, 2018
Total Practice Duration ~12 Years of Practice (2006 – 2018)

Professional Overview & Biography Verified Profile Summary

Mohammad Khadiv was a registered Dentist - General Practice practicing in Wilmington, CA. Throughout an active medical career spanning 12 years, Mohammad Khadiv provided care at the practice location at 1610 N AVALON BLVD until profile deactivation on 2018-12-17.

Practice Location & Contact Primary Location

Practice Address

1610 N Avalon Blvd

Wilmington, CA 907441431

Telephone 3108353131
Associated Practice Facility / Clinic
🏢 Consumerhealth, Inc. Facility NPI 1578770186

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Wilmington, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
7 Specialists

Practicing in Wilmington, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 39885

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Tuankiet Ly , DDS

Dentist - General Practice

NPI 1043387228

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 17, 2018

Record deactivated on December 17, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1610 N AVALON BLVD, WILMINGTON, CA 907441431 (Tel: 3108353131)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 3430, FULLERTON, CA 928343430 (Tel: 3108353131)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MOHAMMAD KHADIV

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #39885 in CA)

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Initial NPI Registration & Enumeration December 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013085281
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 04, 2006
Last Update: July 08, 2007
Deactivation Date: December 17, 2018

Mailing Address

Po Box 3430

Fullerton, CA 928343430

Phone: 3108353131

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.