Omid Kiarash, DMD, MSD
Individual provider Active NPI Periodontics · Dunkirk, MD
NPI 1386534816 · NPPES record last updated Jul 7, 2025
Key facts
- NPI
- 1386534816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 17508 (MD)
- Practice address
- 10845 Town Center Blvd Ste 102
Dunkirk, MD 20754-2712 - Phone
- (301) 494-2029
- NPI assigned
- Jul 7, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17508 | MD | MD | Periodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 17508 | MD | Yes |
Addresses
Primary practice location
10845 Town Center Blvd Ste 102
Dunkirk, MD 20754-2712
Mailing address
6817 Penngrove LN
Bethesda, MD 20817-1594
Phone (514) 967-9299
Other providers in Dunkirk, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.