Kayvan Shahrzad, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401415346 Issued in VA

Practice address

9842 Corsini CT
Vienna, VA 22182-3016

Phone

(217) 540-5100

NPI assigned

Jan 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 VA

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1457896318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9842 CORSINI CT",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9842 CORSINI CT",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823016",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRZAD",
        "first_name": "KAYVAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bahman Shahin, MD
• Martin A Shahmirzadi
• Shahram Sabet DDS, PC
• Shohreh Shahram, DDS
• Mitra Shahryary, LCSW
• Ismaiel Shaikh
• Shahla Shakeri
• Ahmad Zafar Shakibi
• Sara Shambayati, DDS
• Shanghai Chinese Medicine Clinic

• Dentist in Vienna, VA
• Providers in Vienna, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.