Active NPI
Maryam Bangash
- Dentist
- Lake Wales, FL
National Provider Identifier
1134568587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN20272
- Practice address
- 24185 US Highway 27
Lake Wales, FL 33859-7819 - Phone
- (863) 455-7444
- NPI assigned
- Jun 19, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160726001814 | FL | Order and Referring Only - Dentist | 6507159712 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 | DN20272 | FL | Primary |
Addresses
Primary practice location
24185 US Highway 27
Lake Wales, FL 33859-7819
Mailing address
24185 US Highway 27
Lake Wales, FL 33859-7819
NPI Registry JSON
{
"created_epoch": "1371600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1134568587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24185 US HIGHWAY 27",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338597819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24185 US HIGHWAY 27",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338597819",
"telephone_number": "863-455-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGASH",
"first_name": "MARYAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-19",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN20272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.