Individual provider Active NPI

Mohammed Homer Naimee, DDS

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1194386185
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12554 Issued in CT
Practice address
129 York St
New Haven, CT 06511-5608
Phone
(703) 629-0514
NPI assigned
Jun 21, 2019
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12554 CT Primary

Addresses

Primary practice location

129 York St
New Haven, CT 06511-5608

Mailing address

1619 Colonial Hills Dr
MC Lean, VA 22102-2940
Phone (703) 629-0514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200814000447 CT Order and Referring Only - DentistPractitioner - Dentist 8224454723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12554CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1194386185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 COLONIAL HILLS DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221022940",
            "telephone_number": "703-629-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115608",
            "telephone_number": "703-629-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIMEE",
        "first_name": "MOHAMMED",
        "middle_name": "HOMER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.