Kiarash Yeganegi, DDS, MSD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

059508 Issued in NY

Practice address

3903 Brewerton Rd
North Syracuse, NY 13212-3704

Phone

(315) 999-3636

Fax

(315) 999-1312

NPI assigned

Apr 20, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Yeganegi Endodontics PLLC

  • Endodontics
  • North Syracuse, NY
  • NPI 1659962843
  NPD Authorized official
• Jose M Alvarez DDS PLLC

  • General Practice Dentistry
  • Cicero, NY
  • NPI 1790447712
  NPD (past)
• Millennium Children Home Care

  • Home Health Agency
  • Poughkeepsie, NY
  • NPI 1801432935
  NPD (past)

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1255866836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEADOW LN",
            "city": "N SYRACUSE",
            "state": "NY",
            "postal_code": "132122160",
            "telephone_number": "901-848-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 BREWERTON RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123704",
            "telephone_number": "315-999-3636",
            "fax_number": "315-999-1312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8057 Brewerton Rd",
            "address_purpose": "LOCATION",
            "city": "Cicero",
            "state": "NY",
            "postal_code": "130399585",
            "country_code": "US",
            "telephone_number": "315-698-0040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "521 Vischer Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653668",
            "country_code": "US",
            "telephone_number": "518-383-4484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEGANEGI",
        "first_name": "KIARASH",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "059508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Wilsey
• Nicole Wise
• Catherine Elizabeth Woods, LMT
• Xuemei Yao, NP
• Yeganegi Endodontics PLLC
• Darryl K Young, PHYSICAL THERAPIST
• Sandrine Nelly Yowou Nzofang
• Yuhas Nutrition, PLLC
• Jonathan M Yuhas, MS, RD, CDN
• Sergio Zappala, PHYSICAL THERAPIST

• Endodontics in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.