Reza Keshmiri, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15696 Issued in MD

Practice address

9 Bronco CT
Germantown, MD 20874-6124

Phone

(510) 206-4854

NPI assigned

Sep 22, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Dr. Mohammadreza Keshmiri Former name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1003218009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BRONCO CT",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746124",
            "telephone_number": "510-206-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BRONCO CT",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208746124",
            "telephone_number": "510-206-4854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHMIRI",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-22",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15696",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15696",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1001440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMADREZA",
            "last_name": "KESHMIRI",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mindi W Keele
• Louise Kelley, PT
• Kenneth a Piering DC PC
• Irene Kenyenso
• Alexander Philip Kern, DPT
• Morgan Key
• Anjita K Khadka, PT
• Sarmad Khamas, D.M.D
• Barke Ahmed Khamis
• Asma Khan

• General Practice Dentistry in Germantown, MD
• Providers in Germantown, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.