Individual provider Active NPI

Rod Ali Erfani, DMD

  • Dentist
  • Louisville, KY
National Provider Identifier
1043670391
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10177 Issued in KY
Practice address
2215 Portland Ave
Louisville, KY 40212
Phone
(502) 772-8160
Fax
(502) 772-8108
NPI assigned
Feb 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10177 KY Primary

Addresses

Primary practice location

2215 Portland Ave
Louisville, KY 40212

Mailing address

PO Box 950244
Louisville, KY 40295-0244
Phone (812) 218-8926

Other practice location 1

3600 W Belmont Ave
Chicago, IL 60618
Phone (773) 433-8300

Other practice location 2

3600 W Belmont Ave
Chicago, IL 60618
Phone (773) 433-8300

Other practice location 3

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-3625

Other practice location 4

712 E Muhammad Ali Blvd
Louisville, KY 40202-1643
Phone (502) 568-6972

Other practice location 5

834 E Broadway
Louisville, KY 40204-1072
Phone (502) 679-7332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011001681 KY Order and Referring Only - DentistPractitioner - Dentist 9133471667

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": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1043670391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950244",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950244",
            "telephone_number": "812-218-8926",
            "fax_number": "812-218-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40212",
            "telephone_number": "502-772-8160",
            "fax_number": "502-772-8108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60618",
            "country_code": "US",
            "telephone_number": "773-433-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60618",
            "country_code": "US",
            "telephone_number": "773-433-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-3625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "712 E Muhammad Ali Blvd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021643",
            "country_code": "US",
            "telephone_number": "502-568-6972",
            "fax_number": "502-569-6201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "834 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402041072",
            "country_code": "US",
            "telephone_number": "502-679-7332",
            "fax_number": "502-679-7320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERFANI",
        "first_name": "ROD",
        "middle_name": "ALI",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.