Kevin Ghiani, DDS

Key facts

NPI

1508923111

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

46947 (CA)

Practice address

6739 3/4 Fallbrook Ave
West Hills, CA 91307-3522

Phone

(818) 592-6060

Fax

(818) 592-6306

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Keyvan Sadaghiani-Aval, DDS a Professional Corporation. General Practice Dentistry · West Hills, CA · NPI 1952791816
  NPD (past) Authorized official GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Specialties & licenses

Addresses

Other identifiers

Other names

• Keyvan Sadaghiani Aval Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 17, 2014.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1508923111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6739 3/4 FALLBROOK AVE",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073522",
            "telephone_number": "818-592-6060",
            "fax_number": "818-592-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6739 3/4 FALLBROOK AVE",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913073522",
            "telephone_number": "818-592-6060",
            "fax_number": "818-592-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIANI",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1508923111",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEYVAN",
            "last_name": "SADAGHIANI AVAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in West Hills, CA · General Practice Dentistry in California