Mohammed R. Kayyali, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6928 Issued in OK

Practice address

1921 Stonecipher Blvd
Ada, OK 74820

Phone

(580) 319-6027

NPI assigned

Jun 3, 2017

Sex

Male

Sole proprietor

No

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

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496448000000",
    "number": "1396273314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 S ROCKFORD PKWY",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013031",
            "telephone_number": "580-319-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "74820",
            "telephone_number": "580-319-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYYALI",
        "first_name": "MOHAMMED",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-03",
        "last_updated": "2017-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald E Joseph, CRNA
• Journey Therapeutic Services PLLC
• Edith Ann Kalkbrenner Burr, P.A.
• Kimberly W Kaniatobe
• Lindsay Kates, APRN-CNP
• Bonnie Keeley, MS, LPC
• Lesley Nicole Keesee, APRN
• Jennifer Kellner
• Brendan Kellogg, B.A.
• Kendra Burnside LCSW Inc PC

• Dentist in Ada, OK
• Providers in Ada, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.