Organization Active NPI

Dr Ahmad a. Beydoun DDS , PC

  • General Practice Dentistry
  • Dearborn, MI
National Provider Identifier
1154433522
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16362 Issued in MI
Legal business name
DR AHMAD A. BEYDOUN DDS , PC
Practice address
10033 Vernor Hwy
Dearborn, MI 48120-1513
Phone
(313) 843-6530
Fax
(313) 843-1410
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ahmad A Beydoun, DDSNPI 1972611028
Title
Dentist
Phone
(313) 843-6530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16362 MI Primary

Addresses

Primary practice location

10033 Vernor Hwy
Dearborn, MI 48120-1513

Mailing address

10033 Vernor Hwy
Dearborn, MI 48120-1513
Phone (313) 843-6530

Other identifiers 1

IdentifierTypeStateIssuer
4881109MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154433522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10033 VERNOR HWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201513",
            "telephone_number": "313-843-6530",
            "fax_number": "313-843-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10033 VERNOR HWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201513",
            "telephone_number": "313-843-6530",
            "fax_number": "313-843-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR AHMAD A. BEYDOUN DDS , PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEYDOUN",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "313-843-6530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4881109",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.