Individual provider Active NPI

Kaveh Niknia, DDS

  • General Practice Dentistry
  • Newport Beach, CA
National Provider Identifier
1104836667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48158 Issued in CA
Practice address
3101 W Coast Highway
St 309
Newport Beach, CA 92663-4034
Phone
(949) 650-6111
Fax
(949) 650-0391
NPI assigned
Aug 8, 2006
Sex
Male
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 48158 CA Primary

Addresses

Primary practice location

3101 W Coast Highway
St 309
Newport Beach, CA 92663-4034

Mailing address

3101 W Coast Highway
St 309
Newport Beach, CA 92663-4034
Phone (949) 650-6111

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
48158CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104836667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W COAST HIGHWAY",
            "address_2": "ST 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634034",
            "telephone_number": "949-650-6111",
            "fax_number": "949-650-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W COAST HIGHWAY",
            "address_2": "ST 309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634034",
            "telephone_number": "949-650-6111",
            "fax_number": "949-650-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKNIA",
        "first_name": "KAVEH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

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.