Active NPI
Reza Kasiri, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Diego, CA
National Provider Identifier
1164525697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- B36309
- Practice address
- 6755 Mira Mesa Blvd
Suite 218
San Diego, CA 92121 - Phone
- (858) 552-0052
- Fax
- (858) 576-1990
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- 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 | B36309 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | B36309 | CA | Primary |
Addresses
Primary practice location
6755 Mira Mesa Blvd
Suite 218
San Diego, CA 92121
Mailing address
6755 Mira Mesa Blvd
Suite 218
San Diego, CA 92121
Phone (858) 552-0052
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 |
|---|---|---|---|
| B36309 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reza Kasiri | 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.
-
- Exclusive Provider Organization
- San Diego, CA
- NPI 1992044036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1164525697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6755 MIRA MESA BLVD",
"address_2": "SUITE 218",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92121",
"telephone_number": "858-552-0052",
"fax_number": "858-576-1990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6755 MIRA MESA BLVD",
"address_2": "SUITE 218",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92121",
"telephone_number": "858-552-0052",
"fax_number": "858-576-1990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASIRI",
"first_name": "REZA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "B36309",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "B36309",
"primary": true
}
],
"identifiers": [],
"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 Sep 11, 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.