Individual provider Active NPI

Mikaeya Kalantari, DDS

  • Pediatric Dentistry
  • Mission Viejo, CA
National Provider Identifier
1609188994
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2010016138 Issued in MO
Practice address
27725 Santa Margarita Pkwy Ste 270
Mission Viejo, CA 92691-6708
Phone
(949) 951-0951
Fax
(949) 652-3445
NPI assigned
Jul 2, 2010
Last updated
Apr 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2010016138 MO Primary

Addresses

Primary practice location

27725 Santa Margarita Pkwy Ste 270
Mission Viejo, CA 92691-6708

Mailing address

27725 Santa Margarita Pkwy Ste 270
Mission Viejo, CA 92691-6708
Phone (949) 951-0951

Other practice location 1

2401 Gillham Rd
Gme
Kansas City, MO 64108-4619
Phone (816) 234-3000

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
2010016138MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mikaeya Kalantari Dental Corporation Pediatric Dentistry CurrentSince Apr 26, 2020 Accepting new patients
Zaery Kalantari Dental Group Inc Pediatric Dentistry PastSince Apr 26, 2020 Accepting new patients

Locations

27725 Santa Margarita Pkwy
Ste 270
Mission Viejo, CA 92691
Phone (949) 951-0951

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1609188994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27725 SANTA MARGARITA PKWY STE 270",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916708",
            "telephone_number": "949-951-0951",
            "fax_number": "949-652-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27725 SANTA MARGARITA PKWY STE 270",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916708",
            "telephone_number": "949-951-0951",
            "fax_number": "949-652-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_2": "GME",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-234-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALANTARI",
        "first_name": "MIKAEYA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2010016138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.