MEDICARE: DR. ROYA NIAKIANI DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1649111261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ROYA NIAKIANI DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	4428 CONVOY STREET, STE 230
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111
Country	:	US
Telephone Number	:	858-573-2833
Fax Number	:

Provider Business Practice Location Address
First Line	:	4428 CONVOY STREET, STE 230
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111
Country	:	US
Telephone Number	:	858-573-2833
Fax Number	:

Authorized Official
Title or Position	:	OWN/PRESIDENT
Name	:	DR. ROYA NIAKIANI
Credential	:	D.M.D.
Telephone Number	:	858-573-2833

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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