Individual provider Active NPI

Ahmad Shaun Zand, DDS

  • Dentist
  • E Lansing, MI
National Provider Identifier
1215042304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17374 Issued in MI
Practice address
702 W Lake Lansing Rd
E Lansing, MI 48823
Phone
(517) 394-5181
Fax
(517) 394-6764
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17374 MI Primary

Addresses

Primary practice location

702 W Lake Lansing Rd
E Lansing, MI 48823

Mailing address

702 W Lake Lansing Rd
E Lansing, MI 48823
Phone (517) 394-5181

Other names 1

  • Dr. Ahmad Reza Zand Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160426000357 MI Order and Referring Only - DentistPractitioner - Dentist 2769781756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17374MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215042304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W LAKE LANSING RD",
            "city": "E LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-394-5181",
            "fax_number": "517-394-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W LAKE LANSING RD",
            "city": "E LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-394-5181",
            "fax_number": "517-394-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAND",
        "first_name": "AHMAD",
        "middle_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "17374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AHMAD",
            "last_name": "ZAND",
            "middle_name": "REZA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in E Lansing, MI

Sources for this page

Verify at the official NPI Registry.