Individual provider Active NPI

Kianoosh Behshid, DDS

  • General Practice Dentistry
  • Des Moines, WA
National Provider Identifier
1053438523
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00009985 Issued in WA
Practice address
22625 Pacific Hwy S
Des Moines, WA 98198-5110
Phone
(206) 878-5665
Fax
(206) 870-1504
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00009985 WA Primary

Addresses

Primary practice location

22625 Pacific Hwy S
Des Moines, WA 98198-5110

Mailing address

22625 Pacific Hwy S
Des Moines, WA 98198-5110
Phone (206) 878-5665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE00009985WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053438523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22625 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981985110",
            "telephone_number": "206-878-5665",
            "fax_number": "206-870-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22625 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981985110",
            "telephone_number": "206-878-5665",
            "fax_number": "206-870-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHSHID",
        "first_name": "KIANOOSH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.