Jaleh Tina Keyhani, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS60131 Issued in CA

Practice address

1590 Webster St Ste E
Fairfield, CA 94533-4932

Phone

(707) 759-5550

NPI assigned

Jun 13, 2005

Reactivated

Mar 23, 2006

Last updated

Apr 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Ohio State University College of Dentistry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18519/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• M Elder D D S a Professional Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Pinole, CA
  • NPI 1760633341
  Medicare reassignment
• Shafa Medical Clinic PC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1194906925
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1043214448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 E SUTTON DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852604929",
            "telephone_number": "602-318-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 WEBSTER ST STE E",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334932",
            "telephone_number": "707-759-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYHANI",
        "first_name": "JALEH",
        "middle_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS60131",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D5160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529604",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christie L. Kennedy, MSN, FNP
• Sandra Kennedy, P.T.
• Bernard Keovoravongsa
• Stephan Kesterson, PHYSICIAN ASSISTANT
• Amy Jo Keyes, PA-C
• Herkanwal S. Khaira, MD
• Deepkamel Kaur Khakh
• Cathleen Cameron Khan
• Parveen Khan, MD
• Sazia Loreen Khan

• Oral and Maxillofacial Surgery (Dentist) in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.