Active NPI
Mahum Abbas Mirza
- Dentist
- Omaha, NE
National Provider Identifier
1225524770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7481
- Practice address
- 13625 California St Ste 300
Omaha, NE 68154-5246 - Phone
- (402) 933-8005
- NPI assigned
- Jul 9, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 7481 | NE | Primary |
Addresses
Primary practice location
13625 California St Ste 300
Omaha, NE 68154-5246
Mailing address
3157 Farnam St Apt 7331
Omaha, NE 68131-3544
Phone (440) 391-1878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7481 | NE | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Dental, P.C. | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Omaha, NE
- NPI 1932233095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1225524770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3157 FARNAM ST APT 7331",
"city": "OMAHA",
"state": "NE",
"postal_code": "681313544",
"telephone_number": "440-391-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13625 CALIFORNIA ST STE 300",
"city": "OMAHA",
"state": "NE",
"postal_code": "681545246",
"telephone_number": "402-933-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRZA",
"first_name": "MAHUM",
"middle_name": "ABBAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-09",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "7481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.