Individual provider Active NPI

Kemia Lillian Zeinali

  • Dentist
  • San Diego, CA
National Provider Identifier
1083109813
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS103514 Issued in CA
Practice address
10585 Stony Ridge Way
San Diego, CA 92131-6139
Phone
(858) 335-7364
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS103514 CA Primary

Addresses

Primary practice location

10585 Stony Ridge Way
San Diego, CA 92131-6139

Mailing address

10585 Stony Ridge Way
San Diego, CA 92131-6139
Phone (858) 335-7364

Other identifiers 1

IdentifierTypeStateIssuer
34217OtherTXADA

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
DDS103514CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Zeinali DMD Corp Dentist CurrentSince Jun 26, 2022 Accepting new patients

Locations

6815 Eastern Ave
Ste A
Bell Gardens, CA 90201
Phone (858) 335-7364

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.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1083109813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10585 STONY RIDGE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921316139",
            "telephone_number": "858-335-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10585 STONY RIDGE WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921316139",
            "telephone_number": "858-335-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEINALI",
        "first_name": "KEMIA",
        "middle_name": "LILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS103514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADA",
            "identifier": "34217",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.