Active NPI
Ahmad Deebajah
- Dentist
- Troy, MI
National Provider Identifier
1114210002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020359
- Practice address
- 3144 John R Rd
Suite 100
Troy, MI 48083-5936 - Phone
- (248) 510-1100
- Fax
- (248) 251-0073
- NPI assigned
- May 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901020359 | MI | Primary |
Addresses
Primary practice location
3144 John R Rd
Suite 100
Troy, MI 48083-5936
Mailing address
3144 John R Rd
Suite 100
Troy, MI 48083-5936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161013000980 | MI | Order and Referring Only - Dentist | 8628256419 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1114210002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3144 JOHN R RD",
"address_2": "SUITE 100",
"city": "TROY",
"state": "MI",
"postal_code": "480835936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3144 JOHN R RD",
"address_2": "SUITE 100",
"city": "TROY",
"state": "MI",
"postal_code": "480835936",
"telephone_number": "248-510-1100",
"fax_number": "248-251-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEEBAJAH",
"first_name": "AHMAD",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-25",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901020359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.