Individual provider Active NPI

Amen Sarfraz, DMD

  • General Practice Dentistry
  • Janesville, WI
National Provider Identifier
1144887464
Registry record updated Sep 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1002229-15 Issued in WI
Practice address
3131 Milton Ave Ste 190
Janesville, WI 53545-0244
Phone
(608) 322-4444
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019032087 IL
General Practice Dentistry 1223G0001X 1002229-15 WI Primary

Addresses

Primary practice location

3131 Milton Ave Ste 190
Janesville, WI 53545-0244

Mailing address

1770 Gateway Blvd Apt 750
Beloit, WI 53511-9037
Phone (408) 807-1627

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
019032087ILMDDentist
1002229-15WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1144887464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 GATEWAY BLVD APT 750",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535119037",
            "telephone_number": "408-807-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 MILTON AVE STE 190",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450244",
            "telephone_number": "608-322-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARFRAZ",
        "first_name": "AMEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032087",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002229-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.