Individual provider Active NPI

Anita Kianimanesh, D.M.D

  • General Practice Dentistry
  • Lauderhill, FL
National Provider Identifier
1629273164
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17984 Issued in FL
Practice address
7100 W Commercial Blvd
Lauderhill, FL 33319-2155
Phone
(954) 741-6556
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17984 FL Primary

Addresses

Primary practice location

7100 W Commercial Blvd
Lauderhill, FL 33319-2155

Mailing address

3150 W Rolling Hills Cir
#604
Davie, FL 33328-1950
Phone (954) 536-4397

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
DN17984FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629273164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 W ROLLING HILLS CIR",
            "address_2": "#604",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281950",
            "telephone_number": "954-536-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W COMMERCIAL BLVD",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333192155",
            "telephone_number": "954-741-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIANIMANESH",
        "first_name": "ANITA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.