Active NPI
Keri Ann Izadi, DMD
- Dentist
- Fredericksburg, VA
National Provider Identifier
1326266149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS035162
- Practice address
- 409 Chatham Square Office Park
Fredericksburg, VA 22405 - Phone
- (540) 645-9296
- Fax
- (540) 301-5513
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS035162 | PA | Primary |
Addresses
Primary practice location
409 Chatham Square Office Park
Fredericksburg, VA 22405
Mailing address
409 Chatham Square Office Park
Fredericksburg, VA 22405
Phone (540) 371-4131
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035162 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waterfront Anesthesia Associates, LLC | 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.
-
- Anesthesiology Physician
- Homestead, PA
- NPI 1053359547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1326266149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 CHATHAM SQUARE OFFICE PARK",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22405",
"telephone_number": "540-371-4131",
"fax_number": "540-301-5513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 CHATHAM SQUARE OFFICE PARK",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "22405",
"telephone_number": "540-645-9296",
"fax_number": "540-301-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZADI",
"first_name": "KERI",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS035162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.