Individual provider Active NPI

Kianna Memaran, DMD

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1053970061
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D010342 Issued in AZ
Practice address
10901 E McDowell Rd
Scottsdale, AZ 85256-5300
Phone
(480) 278-7742
NPI assigned
Jun 12, 2019
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D010342 AZ Primary

Addresses

Primary practice location

10901 E McDowell Rd
Scottsdale, AZ 85256-5300

Mailing address

2217 W Happy Valley Rd Ste 100
Phoenix, AZ 85085-1604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20241120000750 TX Practitioner - Dentist 4385179936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D010342AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Salt River Pima-Maricopa Indian Community CurrentSince Nov 8, 2024 Accepting new patients
Salt River Pima-Maricopa Indian Community CurrentSince Nov 8, 2024 Accepting new patients
Norterra Dental Group and Orthodontics, LLP General Practice Past Accepting new patients

Locations

10901 E McDowell Rd
Scottsdale, AZ 85256
Phone (480) 278-7742

Interoperability endpoints

  • Direct secure messaging: kmemaran701784@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1053970061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 W HAPPY VALLEY RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850851604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 E MCDOWELL RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852565300",
            "telephone_number": "480-278-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMARAN",
        "first_name": "KIANNA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.