Individual provider Active NPI

Lana Kayata, DMD

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1780425207
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012147 Issued in AZ
Practice address
1003 N Dobson Rd Ste 101
Mesa, AZ 85201-7665
Phone
(480) 267-9920
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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 D012147 AZ Primary

Addresses

Primary practice location

1003 N Dobson Rd Ste 101
Mesa, AZ 85201-7665

Mailing address

1003 N Dobson Rd Ste 101
Mesa, AZ 85201-7665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20240925003016 AZ Order and Referring Only - DentistPractitioner - Dentist 2860933249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012147AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Modern Dentistry, LLP General Practice PastSince Jun 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1780425207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N DOBSON RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 N DOBSON RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017665",
            "telephone_number": "480-267-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYATA",
        "first_name": "LANA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.