Active NPI
Kamal Ahmed, DDS
- General Practice Dentistry
- Big Lake, MN
National Provider Identifier
1013060706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D11984
- Practice address
- 195 Jefferson Blvd
Big Lake, MN 55309-9572 - Phone
- (763) 263-2222
- Fax
- (763) 263-5822
- NPI assigned
- Jan 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11984 | MN | Primary |
Addresses
Primary practice location
195 Jefferson Blvd
Big Lake, MN 55309-9572
Mailing address
195 Jefferson Blvd
Big Lake, MN 55309-9572
Phone (763) 263-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11984 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Dental Professionals MN PC | General Practice | Past | Accepting new patients |
| Dental Services Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Midwest Dental
- General Practice Dentistry
- Big Lake, MN
- NPI 1215307061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013060706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 JEFFERSON BLVD",
"city": "BIG LAKE",
"state": "MN",
"postal_code": "553099572",
"telephone_number": "763-263-2222",
"fax_number": "763-263-5822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 JEFFERSON BLVD",
"city": "BIG LAKE",
"state": "MN",
"postal_code": "553099572",
"telephone_number": "763-263-2222",
"fax_number": "763-263-5822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "KAMAL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D11984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.