Individual provider Active NPI

Alyzah Usman Quereshy, DMD

  • Dental Anesthesiology
  • Columbus, OH
National Provider Identifier
1093382558
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
30.026536 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2639
Phone
(614) 722-4200
Fax
(614) 722-4203
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X 30.026536 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2639

Mailing address

700 Childrens Dr
Columbus, OH 43205-2639
Phone (614) 722-4200

Other practice location 1

405 Butterfly Gardens
Columbus, OH 43215-3427
Phone (614) 722-4200

Other practice location 2

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-4200

Other practice location 3

380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-4200

Other identifiers 1

IdentifierTypeStateIssuer
0048891MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240715001249 OH Practitioner - Dental Anesthesiology 7214472299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.026536OHMDDentist Anesthesiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Anesthesia Associates Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

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.

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1093382558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Butterfly Gardens",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432153427",
            "country_code": "US",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUERESHY",
        "first_name": "ALYZAH",
        "middle_name": "USMAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "OH",
            "license": "30.026536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048891",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.