Individual provider Active NPI

Keyan Bashiri, DDS

  • Pediatric Dentistry
  • Staunton, VA
National Provider Identifier
1265288740
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401419985 Issued in VA
Practice address
15 Gosnell Xing
Staunton, VA 24401-6297
Phone
(540) 213-2244
NPI assigned
Apr 25, 2024
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401419985 VA Primary

Addresses

Primary practice location

15 Gosnell Xing
Staunton, VA 24401-6297

Mailing address

15 Gosnell Xing
Staunton, VA 24401-6297
Phone (540) 213-2244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240611001388 IN Order and Referring Only - DentistPractitioner - Dentist 4082156641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401419985VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Sedation LLC PastSince Jan 4, 2026 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, 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": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1265288740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GOSNELL XING",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016297",
            "telephone_number": "540-213-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GOSNELL XING",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016297",
            "telephone_number": "540-213-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIRI",
        "first_name": "KEYAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-25",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401419985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

Verify at the official NPI Registry.