Individual provider Active NPI

Kaveh Ahani, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Pittsburgh, PA
National Provider Identifier
1669877577
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
62781 Issued in CA
Practice address
203 Lothrop St
Suite 204
Pittsburgh, PA 15213-2548
Phone
(412) 648-6801
Fax
(412) 648-6835
NPI assigned
Nov 4, 2014
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 62781 CA Primary

Addresses

Primary practice location

203 Lothrop St
Suite 204
Pittsburgh, PA 15213-2548

Mailing address

203 Lothrop St
Suite 204
Pittsburgh, PA 15213-2548
Phone (412) 648-6801

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522000383 CA Practitioner - Otolaryngology 6406199033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

360 Rush Dr
San Marcos, CA 92078-7901
Phone (833) 574-2273

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

5893 Copley Dr
San Diego, CA 92111-7906
Phone (858) 616-5499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 18, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 18, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

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": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1669877577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 LOTHROP ST",
            "address_2": "SUITE 204",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132548",
            "telephone_number": "412-648-6801",
            "fax_number": "412-648-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 LOTHROP ST",
            "address_2": "SUITE 204",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132548",
            "telephone_number": "412-648-6801",
            "fax_number": "412-648-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHANI",
        "first_name": "KAVEH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-04",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.