NPIMap

Organization Active NPI

K. Kevin Neshat, DDS, MD, PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Raleigh, NC
National Provider Identifier
1770637779
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
6503 Issued in NC
Legal business name
K. KEVIN NESHAT, DDS, MD, PA
Practice address
8305 Falls of Neuse Rd
Suite 105
Raleigh, NC 27615-3546
Phone
(919) 841-1720
Fax
(919) 841-1725
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Authorized official

Name
Dr. Khashayar Kevin Neshat, DDS, MD
Title
President
Phone
(919) 841-1720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 6503 NC Primary

Addresses

Primary practice location

8305 Falls of Neuse Rd
Suite 105
Raleigh, NC 27615-3546

Mailing address

8305 Falls of Neuse Rd
Suite 105
Raleigh, NC 27615-3546
Phone (919) 841-1720

Other identifiers 2

IdentifierTypeStateIssuer
2428852OtherNCMEDICARE ID P10#
902AFOtherNCBCBS

Other names 1

  • Nu-Image Surgical Center Doing business as

National Provider Directory

National Provider Directory

Locations

100 Osterville Dr
Holly Springs, NC 27540

7920 Acc Blvd
Ste 130
Raleigh, NC 27617
Phone (919) 251-8036

8305 Falls of Neuse Rd
Ste 105
Raleigh, NC 27615
Phone (919) 841-1720

1725 S Main St
Ste 101
Wake Forest, NC 27587
Phone (919) 841-1720

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1770637779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "919-841-1720",
            "fax_number": "919-841-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8305 FALLS OF NEUSE RD",
            "address_2": "SUITE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153546",
            "telephone_number": "919-841-1720",
            "fax_number": "919-841-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. KEVIN NESHAT, DDS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "NESHAT",
        "authorized_official_first_name": "KHASHAYAR",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-841-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "6503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID P10#",
            "identifier": "2428852",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "902AF",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nu-Image Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.