Individual provider Active NPI

Reza M. Madani, AAS,BS,DMD,FAGD

  • Dentist
  • Framingham, MA
National Provider Identifier
1225068133
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19705 Issued in MA
Practice address
883 Edgell Rd
Suites #201-3
Framingham, MA 01701-3978
Phone
(508) 877-7760
Fax
(508) 877-7776
NPI assigned
Jul 4, 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 19705 MA Primary

Addresses

Primary practice location

883 Edgell Rd
Suites #201-3
Framingham, MA 01701-3978

Mailing address

883 Edgell Rd
Suites #201-3
Framingham, MA 01701-3978
Phone (508) 877-7760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150527000470 MA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8527388206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Applied Science, Bachelor of Science

State licenses

LicenseStateTypeSpecialty
19705MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentusa,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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225068133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 EDGELL RD",
            "address_2": "SUITES #201-3",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017013978",
            "telephone_number": "508-877-7760",
            "fax_number": "508-877-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 EDGELL RD",
            "address_2": "SUITES #201-3",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017013978",
            "telephone_number": "508-877-7760",
            "fax_number": "508-877-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADANI",
        "first_name": "REZA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "AAS,BS,DMD,FAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "19705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.