Active NPI
Ashraf Khalid Mahmoud Ahmed, DDS
- Dentist
- San Antonio, TX
National Provider Identifier
1215714589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39995
- Practice address
- 20821 US Highway 281 N Ste 310
San Antonio, TX 78258-7597 - Phone
- (210) 494-4488
- NPI assigned
- Sep 11, 2023
- Last updated
- Sep 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39995 | TX | Primary |
Addresses
Primary practice location
20821 US Highway 281 N Ste 310
San Antonio, TX 78258-7597
Mailing address
22803 US Highway 281 N Apt 11202
San Antonio, TX 78258-2429
Phone (202) 677-8711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240729001334 | TX | Order and Referring Only - Dentist | 2264978097 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stone Oak Modern Dentistry, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Stone Oak Modern Dentistry
- General Practice Dentistry
- San Antonio, TX
- NPI 1952602484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1215714589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22803 US HIGHWAY 281 N APT 11202",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782582429",
"telephone_number": "202-677-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20821 US HIGHWAY 281 N STE 310",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782587597",
"telephone_number": "210-494-4488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "ASHRAF",
"middle_name": "KHALID MAHMOUD",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "39995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.