Individual provider Active NPI

Nashid F Ahmed

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1124581624
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10575 Issued in AZ
Practice address
230 S 12TH Ave
Phoenix, AZ 85007-3101
Phone
(602) 362-0744
NPI assigned
Apr 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 10575 AZ Primary

Addresses

Primary practice location

230 S 12TH Ave
Phoenix, AZ 85007-3101

Mailing address

12841 Freedom Dr
Fishers, IN 46037-5967
Phone (317) 910-2400

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

State licenses

LicenseStateTypeSpecialty
10575AZMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1124581624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12841 FREEDOM DR",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460375967",
            "telephone_number": "317-910-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S 12TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850073101",
            "telephone_number": "602-362-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "NASHID",
        "middle_name": "F",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "10575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.