Individual provider Active NPI

Kian Farzaneh, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Danville, CA
National Provider Identifier
1982621942
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
46587 Issued in CA
Practice address
801 San Ramon Valley Blvd Ste a
Danville, CA 94526-4027
Phone
(925) 831-9217
Fax
(925) 831-9218
NPI assigned
Jul 16, 2006
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 46587 CA Primary

Addresses

Primary practice location

801 San Ramon Valley Blvd Ste a
Danville, CA 94526-4027

Mailing address

801 San Ramon Valley Blvd Ste a
Danville, CA 94526-4027
Phone (925) 831-9217

Other practice location 1

903 San Ramon Valley Blvd
suite 126
Danville, CA 94526-4046
Phone (925) 831-9217

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
I20130509000170 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2567609662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kian Farzaneh D.D.S., Inc Oral and Maxillofacial Surgery CurrentSince May 25, 2021 Accepting new patients

Locations

801 San Ramon Valley Blvd
Ste A
Danville, CA 94526
Phone (925) 831-9217

903 San Ramon Valley Blvd
Ste 126
Danville, CA 94526
Phone (209) 256-1507

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, 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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1982621942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAN RAMON VALLEY BLVD STE A",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264027",
            "telephone_number": "925-831-9217",
            "fax_number": "925-831-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SAN RAMON VALLEY BLVD STE A",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264027",
            "telephone_number": "925-831-9217",
            "fax_number": "925-831-9218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 San Ramon Valley Blvd",
            "address_2": "suite 126",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "CA",
            "postal_code": "945264046",
            "country_code": "US",
            "telephone_number": "925-831-9217",
            "fax_number": "925-831-9218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARZANEH",
        "first_name": "KIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "46587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.