Kayvan Fathimani, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DEN.00204716 Issued in CO

Practice address

10535 Park Meadows Blvd Ste 250
Lone Tree, CO 80124-8401

Phone

(303) 381-7101

NPI assigned

Jan 26, 2011

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

Enrolled in NY, CO2 enrollments

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 2

Specialty

Oral Surgery

Education

University of Toronto Faculty of Dentistry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kfathimani840955@nychhc.direct-ci.com

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.

• Colorado Oral and Facial Cosmetic Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Lone Tree, CO
  • NPI 1336914282
  Medicare reassignment NPD Authorized official
• Dental Specialty Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
  • NPI 1275592693
  Medicare reassignment NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• Sheepshead Bay Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
  • NPI 1336256338
  NPD (past)
• Sheepshead Bay Oral Surgery, PLLC

  • Specialist
  • Brooklyn, NY
  • NPI 1629096276
  NPD (past)

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1396040127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 250",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248401",
            "telephone_number": "303-381-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 250",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248401",
            "telephone_number": "303-381-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1918 Avenue U",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112293906",
            "country_code": "US",
            "telephone_number": "718-743-5400",
            "fax_number": "718-743-4125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATHIMANI",
        "first_name": "KAYVAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-26",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "056659",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00204716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fangman Oral and Facial Surgery Professional LLC
• Dawn Denise Fangrow, CRNA
• Jennifer Farewell, BSN, RN
• Karree Ardith Farmer, RN
• Leah Marie Farrell, NP
• Ann Elizabeth Faucheux, PA
• Leonard Wade Faulk, M.D.
• Kyle Faulkner
• Conner Feeney
• Gregory Joseph Fellman, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.