Individual provider Active NPI

Maheen Kibriya, DMD

  • Dentist
  • Sierra Madre, CA
National Provider Identifier
1508530205
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
106791 Issued in CA
Practice address
468 W Sierra Madre Blvd
Sierra Madre, CA 91024-2314
Phone
(626) 355-0467
NPI assigned
Aug 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 106791 CA Primary

Addresses

Primary practice location

468 W Sierra Madre Blvd
Sierra Madre, CA 91024-2314

Mailing address

27661 Country Lane Rd
Laguna Niguel, CA 92677-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
106791CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1508530205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27661 COUNTRY LANE RD",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 W SIERRA MADRE BLVD",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910242314",
            "telephone_number": "626-355-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIBRIYA",
        "first_name": "MAHEEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-09-20",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Madre, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.