Active NPI
Justin Mark Keyashian, DDS
- Dentist
- Walnut Creek, CA
National Provider Identifier
1609176478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59820
- Practice address
- 106 La Casa Via
280
Walnut Creek, CA 94598-3086 - Phone
- (925) 932-2110
- NPI assigned
- Oct 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 59820 | CA | Primary |
Addresses
Primary practice location
106 La Casa Via
280
Walnut Creek, CA 94598-3086
Mailing address
1132 Maggie LN
Walnut Creek, CA 94597-2568
Phone (424) 288-9830
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
| License | State | Type | Specialty |
|---|---|---|---|
| 59820 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Troy Schmedding DDS | Dentist | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1609176478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1132 MAGGIE LN",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945972568",
"telephone_number": "424-288-9830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LA CASA VIA",
"address_2": "280",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945983086",
"telephone_number": "925-932-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEYASHIAN",
"first_name": "JUSTIN",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-27",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.