DR. MARYAM RUBY KISHTA-DERANI D.D.S.
NPI 1407049810
Dentist in Lansing, MI

Active since August 20, 2007PECOS Enrolled
2815 S PENNSYLVANIA AVE, SUITE 203, LANSING, MI 48910(517) 272-4150 Get Directions Write a Review

NPPES record last updated: August 20, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Maryam Ruby Kishta-derani D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARYAM RUBY KISHTA-DERANI D.D.S. (NPI 1407049810) is an individual dentist in Lansing, Michigan, licensed in Michigan (2901019672) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407049810
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. MARYAM RUBY KISHTA-DERANICredential: D.D.S.
Location Address2815 S PENNSYLVANIA AVE, SUITE 203Lansing, MI 48910-3496
Mailing Address6633 Westwood CtWest Bloomfield, MI 48322-1371 · (248) 408-3136
Sole ProprietorYes
Enumeration DateAugust 20, 2007
NPI 1407049810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in MI · 2901019672
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2815 S PENNSYLVANIA AVE, Lansing, MI 48910

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Maryam Ruby Kishta-derani D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48910 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
2815 S PENNSYLVANIA AVE, SUITE 105
LANSING, MI 48910
Dermatology
2815 S PENNSYLVANIA AVE, STE 107
LANSING, MI 48910
Plastic Surgery
2815 S PENNSYLVANIA AVE, SUITE 5
LANSING, MI 48910
Marriage & Family Therapist
2815 S PENNSYLVANIA AVE, SUITE #2
LANSING, MI 48910
Internal Medicine (Gastroenterology)
2815 S PENNSYLVANIA AVE, SUITE 205
LANSING, MI 48910
Urology
2815 S PENNSYLVANIA AVE, SUITE 103
LANSING, MI 48910
Dermatology
2815 S PENNSYLVANIA AVE, STE 107
LANSING, MI 48910
Physical Therapist
2815 S PENNSYLVANIA AVE, SUITE # 105B
LANSING, MI 48910

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryam Kishta-derani's NPI number?

The NPI number for Maryam Kishta-derani is 1407049810. It was assigned to this individual provider in the NPPES registry on August 20, 2007.

Where is Maryam Kishta-derani located?

Maryam Kishta-derani practices at 2815 S Pennsylvania Ave Suite 203, Lansing, MI 48910. The listed phone number is (517) 272-4150.

What is Maryam Kishta-derani's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Maryam Kishta-derani enrolled in Medicare?

Yes. Maryam Kishta-derani is registered in the Medicare PECOS enrollment system.

What insurance does Maryam Kishta-derani accept?

Health plans from Delta Dental of Michigan list Maryam Kishta-derani as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Maryam Kishta-derani was last updated on August 20, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.