Active NPI
Mazin Nour Ahmed, DDS
- Dentist
- Grand Forks Afb, ND
National Provider Identifier
1144910902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17993
- Practice address
- 1599 J St BLDG 109
Grand Forks Afb, ND 58205-6306 - Phone
- (701) 747-5393
- NPI assigned
- May 15, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 17993 | MD | Primary |
Addresses
Primary practice location
1599 J St BLDG 109
Grand Forks Afb, ND 58205-6306
Mailing address
1901 36TH Ave S Apt 309
Grand Forks, ND 58201-7277
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17993 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1144910902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 36TH AVE S APT 309",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582017277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1599 J ST BLDG 109",
"city": "GRAND FORKS AFB",
"state": "ND",
"postal_code": "582056306",
"telephone_number": "701-747-5393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOUR AHMED",
"first_name": "MAZIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-15",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "17993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks Afb, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.