Individual provider Active NPI

Michael Masood Kiyani, DMD

  • General Practice Dentistry
  • Cumming, GA
National Provider Identifier
1861557191
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN011700 Issued in GA
Practice address
5925 Iron Gate Trce
Cumming, GA 30040-5801
Phone
(770) 888-8834
Fax
(770) 888-8128
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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 DN011700 GA Primary

Addresses

Primary practice location

5925 Iron Gate Trce
Cumming, GA 30040-5801

Mailing address

5925 Iron Gate Trce
Cumming, GA 30040-5801
Phone (770) 888-8834

Other identifiers 1

IdentifierTypeStateIssuer
720526451AMedicaidGA

Other names 1

  • Dr. Masood Haghighi Kiyani Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN011700GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1861557191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 IRON GATE TRCE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405801",
            "telephone_number": "770-888-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 IRON GATE TRCE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405801",
            "telephone_number": "770-888-8834",
            "fax_number": "770-888-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIYANI",
        "first_name": "MICHAEL",
        "middle_name": "MASOOD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720526451A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MASOOD",
            "last_name": "KIYANI",
            "middle_name": "HAGHIGHI",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.