Shahrdad Kazerani, D.M.D, M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901600288 Issued in MI

Practice address

3830 Fort St
Lincoln Park, MI 48146-4107

Phone

(313) 383-6800

NPI assigned

Feb 25, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Downriver Dental Associates P.C.

  • Periodontics
  • Lincoln Park, MI
  • NPI 1336231497
  NPD (past)

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1306206966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 FERN ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734185",
            "telephone_number": "408-239-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464107",
            "telephone_number": "313-383-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2759 Elizabeth Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483283291",
            "country_code": "US",
            "telephone_number": "486-814-4702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAZERANI",
        "first_name": "SHAHRDAD",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901600288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judi Kaakarli, DDS
• Stephen Nicholas Kafkakis, LLBSW
• Frank Kardos III, DC
• Amy Elizabeth Karwowski, LLMSW
• Jafar Kassir
• Patrick James Kelly, DDS
• Kimberly Dean Kemp
• Kennedy Dental Center of Michigan, P.C.
• Khalil and Usen DPM PC
• Khalil and Usen DPM PC II

• Periodontics in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.