Individual provider Active NPI

Razan Barazi, DDS

  • General Practice Dentistry
  • Louisville, KY
National Provider Identifier
1154583409
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9661 Issued in KY
Practice address
1211 W Broadway
Louisville, KY 40203-2082
Phone
(502) 410-2963
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9661 KY Primary
General Practice Dentistry 1223G0001X DN18749 FL

Addresses

Primary practice location

1211 W Broadway
Louisville, KY 40203-2082

Mailing address

1211 W Broadway
Louisville, KY 40203-2082
Phone (502) 410-2963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200326003718 KY Order and Referring Only - DentistPractitioner - Dentist 0244669216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN18749FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1154583409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032082",
            "telephone_number": "502-410-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032082",
            "telephone_number": "502-410-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAZI",
        "first_name": "RAZAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9661",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN18749",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.