Individual provider Active NPI

Tamzid Bin Mafiz, DMD

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1063071595
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D14251 Issued in MN
Practice address
828 Hawthorne Ave E
Saint Paul, MN 55106-3252
Phone
(651) 774-2959
NPI assigned
Jun 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D14251 MN Primary

Addresses

Primary practice location

828 Hawthorne Ave E
Saint Paul, MN 55106-3252

Mailing address

828 Hawthorne Ave E
Saint Paul, MN 55106-3252
Phone (651) 774-2959

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
D14251MNMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1063071595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 HAWTHORNE AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063252",
            "telephone_number": "651-774-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 HAWTHORNE AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551063252",
            "telephone_number": "651-774-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAFIZ",
        "first_name": "TAMZID",
        "middle_name": "BIN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2019; 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.