Individual provider Active NPI

Mariam Naeem, DMD

  • Dentist
  • Irvine, CA
National Provider Identifier
1073997748
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
VA 0401414993 Issued in VA
Practice address
100 Spectrum Center Dr
Suite 1500
Irvine, CA 92618-4962
Phone
(714) 668-1300
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040539 PA
Dentist 122300000X VA 0401414993 VA Primary

Addresses

Primary practice location

100 Spectrum Center Dr
Suite 1500
Irvine, CA 92618-4962

Mailing address

2230 Gallows Rd
Suit 320
Dunn Loring, VA 22027-1101
Phone (703) 573-8664

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS040539PAMDDentist
VA 0401414993VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1073997748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 GALLOWS RD",
            "address_2": "SUIT 320",
            "city": "DUNN LORING",
            "state": "VA",
            "postal_code": "220271101",
            "telephone_number": "703-573-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPECTRUM CENTER DR",
            "address_2": "SUITE 1500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184962",
            "telephone_number": "714-668-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAEEM",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040539",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "VA 0401414993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.