Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Maryam Ruby Kishta-Derani, DDS

Individual provider Dentist · NPI 1407049810

Dr. Maryam Ruby Kishta-Derani, DDS is a Dentist in Lansing, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2815 S Pennsylvania Ave Ste 203
Lansing, MI 48910-3496
Phone: (517) 272-4150
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2901019672 (MI)

Record details

NPI number1407049810
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedAugust 20, 2007
Last updated in NPPESAugust 20, 2007
Mailing address6633 Westwood Ct, West Bloomfield, MI 48322-1371

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