Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mohammad Amin Khoshnevisan, DMD

Individual provider Dentist · NPI 1114308855

Dr. Mohammad Amin Khoshnevisan, DMD is an Oral Surgery in New York, New York. Graduated from Western University of Health Sciences College of Dental Med in 2015, 11 years ago. Practices with Trustees of Columbia University in the City of New York, a 2,250-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois, New York, Ohio and Pennsylvania.

Years since qualifying
11
Trained at
Western University of Health Sciences College of Dental Med
Licensed in
IL, NY, OH, PA
In the registry since
2015
Specialties on file
4
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

630 W 168th St Rm 250
New York, NY 10032-3725
Phone: (212) 342-0424
Fax: (212) 305-9017
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 6218 Glenway Ave, Cincinnati, OH 45211-6314 — (513) 245-8460
  • 1732 S Broad St, Philadelphia, PA 19145-2330 — (301) 801-3998

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 062474 (NY)
Dentist Taxonomy 122300000X · Licence 30.026201 (OH)
Dentist Taxonomy 122300000X · Licence DS042004 (PA)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 018001949 (IL)

Record details

NPI number1114308855
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJune 17, 2015
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolWESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated 2015 (11 years in practice)
Group practice Trustees Of Columbia University In The City Of New York — 2250 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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