Individual provider Active NPI

Shabrez Ahmed, DDS

  • Dentist
  • Woodbridge, VA
National Provider Identifier
1053501205
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411895 Issued in VA
Practice address
5812 Mapledale PLZ
Woodbridge, VA 22193-4535
Phone
(703) 580-9900
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
0401411895VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mapledale Family Dentistry, P.C. Dentist PastSince Nov 21, 2021 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401411895 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

5812 Mapledale PLZ
Woodbridge, VA 22193-4535

Mailing address

5812 Mapledale PLZ
Woodbridge, VA 22193-4535
Phone (703) 580-9900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 25, 2007.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1053501205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 MAPLEDALE PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934535",
            "telephone_number": "703-580-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 MAPLEDALE PLZ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934535",
            "telephone_number": "703-580-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "SHABREZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.

Verify at the official NPI Registry.