Peyman Hedayati, DDS,MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

43017 Issued in CA

Practice address

855 Fountain Grove Pkwy Ste 201
Santa Rosa, CA 95403-5736

Phone

(707) 545-4433

Fax

(707) 545-2424

NPI assigned

Nov 13, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 12, 2018 through Apr 12, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• Facial Surgery Group PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kansas City, MO
  • NPI 1194745620
  NPD (past)
• Kansas City Cleft and Craniofacial Center PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Overland Park, KS
  • NPI 1073258414
  NPD (past)
• University Health Physicians

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1669456257
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336210095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 FOUNTAIN GROVE PKWY STE 201",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035736",
            "telephone_number": "707-545-4433",
            "fax_number": "707-545-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 FOUNTAIN GROVE PKWY STE 201",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035736",
            "telephone_number": "707-545-4433",
            "fax_number": "707-545-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDAYATI",
        "first_name": "PEYMAN",
        "credential": "DDS,MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "43017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caressa Bambi Hearp I
• Jane Ellen Heath, M.D.
• Heather Anderson DDS Inc
• Windi Heaton, RN
• Robert P Heckey, MD
• David Hedden, M.F.T.
• Thomas Rick Hedlund, LMFT
• Nicole Lauren Heeney, PHARMD
• Kristi Heffelfinger, RT
• Yvonne Marie Arline Hefner, FNP-BC

• Oral and Maxillofacial Surgery (Dentist) in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.