Reza Nikpourfard, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15755 Issued in MD

Practice address

700 Prince Frederick Blvd
Prince Frederick, MD 20678-3141

Phone

(410) 414-8333

NPI assigned

Dec 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tidewater LLC

  • Dentist
  • Prince Frederick, MD
  • NPI 1306359054
  NPD (past)
• Wael M. Elosta PLLC

  • Dental Clinic/Center
  • Lansdowne, VA
  • NPI 1154747541
  NPD (past)

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1154499598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SW 30TH AVE STE 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331354731",
            "telephone_number": "703-729-1818",
            "fax_number": "703-729-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783141",
            "telephone_number": "410-414-8333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19415 Deerfield Ave",
            "address_2": "Suite 309",
            "address_purpose": "LOCATION",
            "city": "Lansdowne",
            "state": "VA",
            "postal_code": "201768452",
            "country_code": "US",
            "telephone_number": "703-729-1818",
            "fax_number": "703-729-7776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIKPOURFARD",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15755",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Randolph Newman, MS, LCPC, LCADC
• Nicholson Endodontics LLC
• Heather Nicolle, BCBA, LBA
• Karyn A Nicosia
• Ralph Walter Niemann, DDS MS
• Noah'S Ark ABA LLC
• Susan Jane Noble, D.D.S.
• North American Partners in Anesthesia Maryland LLC
• Leah Nicole Nottingham, FNP-C
• Nissa M. Novas

• General Practice Dentistry in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.