Individual provider Active NPI

Niveen Kryakos

  • Dentist
  • Yuma, AZ
National Provider Identifier
1821780875
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012287 Issued in AZ
Practice address
2060 W 24TH St
Yuma, AZ 85364-6123
Phone
(928) 819-8999
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D012287 AZ Primary
Dentist 122300000X DDS110290 CA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2060 W 24TH St
Yuma, AZ 85364-6123

Mailing address

2980 Epaulette St
San Diego, CA 92123-3113
Phone (619) 402-7989

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260601003585 CA Practitioner - Dentist 8426528316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Western University of Health Sciences College of Dental Med, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1601 Precision Park LN
San Diego, CA 92173-1345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012287AZMDDentist
DDS110290CAMDDentist

Interoperability endpoints

  • Direct secure messaging: niveen.kryakos.p1@direct.sunset.nextgenshare.com

Organizations & group practices 2

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1821780875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 EPAULETTE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233113",
            "telephone_number": "619-402-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646123",
            "telephone_number": "928-819-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYAKOS",
        "first_name": "NIVEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012287",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS110290",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.