Individual provider Active NPI

Mohammad Khairuz Zaman, BDS. MS

  • Prosthodontics
  • Maitland, FL
National Provider Identifier
1114351392
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN19943 Issued in FL
Practice address
158 Lookout PL Ste 101
Maitland, FL 32751-4411
Phone
(407) 682-7774
NPI assigned
Aug 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DN19943 FL Primary

Addresses

Primary practice location

158 Lookout PL Ste 101
Maitland, FL 32751-4411

Mailing address

2351 Winding CV
Oviedo, FL 32765-6376
Phone (407) 922-9872

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN19943FLMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Classic Dental at Maitland LLC Past Accepting new patients

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": "1377302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1114351392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 WINDING CV",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656376",
            "telephone_number": "407-922-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 LOOKOUT PL STE 101",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514411",
            "telephone_number": "407-682-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMAN",
        "first_name": "MOHAMMAD",
        "middle_name": "KHAIRUZ",
        "credential": "BDS. MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-24",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN19943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.