Organization Active NPI

Ardalan Keshtkar DDS Inc

  • Dental Clinic/Center
  • Roseville, CA
National Provider Identifier
1518510643
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ARDALAN KESHTKAR DDS INC
Practice address
10 Sierra Gate PLZ Ste 130
Roseville, CA 95678-6646
Phone
(916) 872-0617
NPI assigned
Jul 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Dr. Ardalan Keshtkar, DDSNPI 1629451232
Title
Dentist
Phone
(916) 784-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10 Sierra Gate PLZ Ste 130
Roseville, CA 95678-6646

Mailing address

PO Box 2202
Orangevale, CA 95662-7432
Phone (916) 915-3390

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Roseville

National Provider Directory

National Provider Directory

Locations

10 Sierra Gate Plz
Ste 130
Roseville, CA 95678
Phone (916) 784-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1518510643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2202",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956627432",
            "telephone_number": "916-915-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SIERRA GATE PLZ STE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786646",
            "telephone_number": "916-872-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDALAN KESHTKAR DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "KESHTKAR",
        "authorized_official_first_name": "ARDALAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "916-784-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Roseville",
            "affiliation": "N",
            "address_1": "10 Sierra Gate Plz Ste 130",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956786646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.