Individual provider Active NPI

Janeen Waddah Asfour, DDS

  • Dentist
  • Springfield, MA
National Provider Identifier
1194286096
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401417947 Issued in VA
Practice address
1795 Main St Ste 212
Springfield, MA 01103-1015
Phone
(413) 507-0115
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858727 MA
Dentist 122300000X 0401417947 VA Primary

Addresses

Primary practice location

1795 Main St Ste 212
Springfield, MA 01103-1015

Mailing address

1795 Main St Ste 212
Springfield, MA 01103-1015
Phone (413) 507-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250519003641 CA Practitioner - Dentist 0042738429 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110165CAMDMarriage & Family Therapist
DN1858727MAMDDentist
0401417947VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Oral & Maxillofacial Surgery CurrentSince May 7, 2025 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince May 7, 2025 Accepting new patients
UCSF Medical Group Business Services CurrentSince May 7, 2025 Accepting new patients
University of California San Francisco CurrentSince May 7, 2025 Accepting new patients
UCSF Oral Medicine Clinic CurrentSince May 7, 2025 Accepting new patients
University of California San Francisco CurrentSince May 7, 2025 Accepting new patients
Asian Americans for Community Involvement of Santa Clara County, Inc Past Accepting new patients

Locations

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

513 Parnassus Ave
Rm S722
San Francisco, CA 94143
Phone (415) 476-2045

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

513 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-1239

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1194286096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 MAIN ST STE 212",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031015",
            "telephone_number": "413-507-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 MAIN ST STE 212",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031015",
            "telephone_number": "413-507-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASFOUR",
        "first_name": "JANEEN",
        "middle_name": "WADDAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858727",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.