Active NPI
Kimia Eftekhar, DDS
- Dentist
- Indian Land, SC
National Provider Identifier
1053802702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9471
- Practice address
- 9709 Redstone Dr Ste 500
Indian Land, SC 29707-5402 - Phone
- (803) 753-1349
- NPI assigned
- May 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 102412 | CA | |
| Dentist | 122300000X | 9471 | SC | Primary |
Addresses
Primary practice location
9709 Redstone Dr Ste 500
Indian Land, SC 29707-5402
Mailing address
8170 S Tryon St Ste C
Charlotte, NC 28273-3354
Other practice location 1
8170 S Tryon St Ste C
Charlotte, NC 28273-3354
Phone (714) 931-0797
Other practice location 2
10092 Charlotte Hwy Ste 107
Indian Land, SC 29707-7202
Phone (714) 931-0797
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9471 | SC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swati Shetty Dental Corporation | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Buena Park, CA
- NPI 1023515558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1053802702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 S TRYON ST STE C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282733354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9709 REDSTONE DR STE 500",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "297075402",
"telephone_number": "803-753-1349"
}
],
"practiceLocations": [
{
"address_1": "8170 S Tryon St Ste C",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282733354",
"country_code": "US",
"telephone_number": "714-931-0797",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10092 Charlotte Hwy Ste 107",
"address_purpose": "LOCATION",
"city": "Indian Land",
"state": "SC",
"postal_code": "297077202",
"country_code": "US",
"telephone_number": "714-931-0797",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EFTEKHAR",
"first_name": "KIMIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-29",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "102412",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "9471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Land, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.