Ardalan Keshtkar, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

63917 Issued in CA

Practice address

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

Phone

(916) 784-0900

NPI assigned

Jun 30, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ardalan Keshtkar DDS Inc

  • Dental Clinic/Center
  • Roseville, CA
  • NPI 1518510643
  NPD Authorized official
• Gill and Lopez Dental Corporation

  • General Practice Dentistry
  • Lincoln, CA
  • NPI 1629163324
  NPD (past)

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1629451232",
    "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": "916-784-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHTKAR",
        "first_name": "ARDALAN",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sierragatefamilydental2019@mailfence.com",
            "affiliation": "N",
            "endpointDescription": "Mail Fence Encrypted Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "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": []
}

• Macie Lynn Kerr, DMD
• Matthew Adam Kerr, D.P.T.
• Jon R Kerschner, MA
• Courtney L Kerstetter
• Lindsey Kerth, DPT
• Kevin J. O'Neill, D.D.S., M.S.D., Inc.
• Kevin R. Hilton, M.D., Inc.
• Michael P. Kezmoh, MD
• Viktoriia Khabibrakhmanova
• Yuliya Khadzhi

• Dentist in Roseville, CA
• Providers in Roseville, CA by specialty
• Dentist in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.