Individual provider Active NPI

Ghazal Ghassemi

  • Dentist
  • Richmond, VA
National Provider Identifier
1134715261
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401418728 Issued in VA
Practice address
520 N 12TH St
Richmond, VA 23298-5064
Phone
(415) 619-8436
NPI assigned
Dec 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401418728 VA Primary
Prosthodontics 1223P0700X IP2001 WV

Addresses

Primary practice location

520 N 12TH St
Richmond, VA 23298-5064

Mailing address

12017 Club Commons Dr
Glen Allen, VA 23059-7028
Phone (415) 619-8436

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ghassemig@vcu.edu VCU School of Dentistry

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
0401418728VAMDDentist
IP2001WVMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1134715261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12017 CLUB COMMONS DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597028",
            "telephone_number": "415-619-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 12TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985064",
            "telephone_number": "415-619-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASSEMI",
        "first_name": "GHAZAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-13",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418728",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WV",
            "license": "IP2001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ghassemig@vcu.edu",
            "affiliation": "Y",
            "affiliationName": "VCU School of Dentistry",
            "address_1": "520 N 12th St",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232985064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.