Sami A Nizam II, MD, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

6484C Issued in AL

Practice address

4590 Woodmere Blvd
Montgomery, AL 36106

Phone

(334) 271-2002

NPI assigned

Mar 21, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Alabama Surgical Arts, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Montgomery, AL
  • NPI 1871085415

  Oral & Maxillofacial Surgery

  NPD (past) Authorized official
• Alabama Oral & Maxillofacial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Montgomery, AL
  • NPI 1073640785
  NPD (past)
• Branman & Devlin MD PLC

  • Specialist
  • Little Rock, AR
  • NPI 1912108945
  NPD (past)

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

{
    "created_epoch": "1269129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1205150190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062918",
            "telephone_number": "334-271-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36106",
            "telephone_number": "334-271-2002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10809 Executive Center Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722116020",
            "country_code": "US",
            "telephone_number": "501-227-0707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12018 Chenal Pkwy",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722112759",
            "country_code": "US",
            "telephone_number": "501-244-3662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10809 Executive Center Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722116020",
            "country_code": "US",
            "telephone_number": "501-227-0707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Bergen St Rm B854",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032495",
            "country_code": "US",
            "telephone_number": "386-344-2816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIZAM",
        "first_name": "SAMI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-21",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02509400",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AR",
            "license": "4193",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "E-10461",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "6484C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea P Nicholson
• Brandon Nicholson
• Nicki Hill Optometry, LLC
• Lyudmila Yuryevna Nikolaychook, DO
• Debra Lynn Nix
• Chika Nnedu
• Noble Counseling Services, LLC
• Johnny Rudolph Nobles III, PHARM. D.
• Noland Hospital Montgomery II, LLC
• Nolrav Health Services, Inc

• Oral & Maxillofacial Surgery (D.M.D.) in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.