Individual provider Active NPI

Aziz Basha, D.D.S.

  • Dentist
  • Rochester, NY
National Provider Identifier
1093048811
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056064 Issued in NY
Practice address
1841 W Ridge Rd
Rochester, NY 14615-2504
Phone
(718) 490-6908
NPI assigned
Sep 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 056064 NY Primary

Addresses

Primary practice location

1841 W Ridge Rd
Rochester, NY 14615-2504

Mailing address

1841 W Ridge Rd
Rochester, NY 14615-2504
Phone (718) 490-6908

Other practice location 1

1000 Hylan Dr
Aspen Dental
Rochester, NY 14623-4218
Phone (585) 292-6300 ext. 2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20211220001316 NY Order and Referring Only - DentistPractitioner - Dentist 7012295918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056064NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093048811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 W RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152504",
            "telephone_number": "718-490-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 W RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152504",
            "telephone_number": "718-490-6908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Hylan Dr",
            "address_2": "Aspen Dental",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146234218",
            "country_code": "US",
            "telephone_number": "585-292-6300 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASHA",
        "first_name": "AZIZ",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.