Individual provider Active NPI

Mohd Majed Kachlan, DDS

  • Dentist
  • Flint, MI
National Provider Identifier
1255503470
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600211 Issued in MI
Practice address
1481 S Center Rd
Flint, MI 48509-1779
Phone
(810) 744-2982
Fax
(810) 744-2983
NPI assigned
Mar 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901600211 MI Primary

Addresses

Primary practice location

1481 S Center Rd
Flint, MI 48509-1779

Mailing address

6455 W Cimarron TRL
Flint, MI 48532-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160526002006 NY Order and Referring Only - DentistPractitioner - Dentist 8224328604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901600211MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Dental Services of Michigan, PC CurrentSince Nov 13, 2022 Accepting new patients
Associated Healthcare Systems, Inc Past Accepting new patients

Locations

1481 S Center Rd
Flint, MI 48509
Phone (810) 373-2261

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1255503470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 W CIMARRON TRL",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485322022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 S CENTER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485091779",
            "telephone_number": "810-744-2982",
            "fax_number": "810-744-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACHLAN",
        "first_name": "MOHD",
        "middle_name": "MAJED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.