Active NPI
Aida Maratovna Rosenthal
- Dentist
- Farmington Hills, MI
National Provider Identifier
1194176065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 059368
- Practice address
- 29402 Laurel Dr
Farmington Hills, MI 48331-2828 - Phone
- (248) 228-0907
- NPI assigned
- Jun 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 059368 | NY | Primary |
Addresses
Primary practice location
29402 Laurel Dr
Farmington Hills, MI 48331-2828
Mailing address
29402 Laurel Dr
Farmington Hills, MI 48331-2828
Phone (248) 228-0907
Other names 1
- Aida Fakhrutdinova
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502928000000",
"number": "1194176065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29402 LAUREL DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483312828",
"telephone_number": "248-228-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29402 LAUREL DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483312828",
"telephone_number": "248-228-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENTHAL",
"first_name": "AIDA",
"middle_name": "MARATOVNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-22",
"last_updated": "2017-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AIDA",
"last_name": "FAKHRUTDINOVA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.