Active NPI
Aiyzah Mansur Javaid, DDS
- Student in an Organized Health Care Education/Training Program
- Bloomington, MN
National Provider Identifier
1003656307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 8170 33Rd Ave S
Bloomington, MN 55425-4516 - Phone
- (952) 541-2802
- NPI assigned
- May 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
8170 33Rd Ave S
Bloomington, MN 55425-4516
Mailing address
515 Huron Blvd SE Apt 403
Minneapolis, MN 55414-3494
Phone (715) 271-6001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241009000790 | MN | Order and Referring Only - Dentist | 3779014196 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1003656307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 HURON BLVD SE APT 403",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554143494",
"telephone_number": "715-271-6001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "952-541-2802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAVAID",
"first_name": "AIYZAH",
"middle_name": "MANSUR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-27",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.