Active NPI
Alfaiyaz Ibrahim, D.D.S.
- Pediatric Dentistry
- Denver, CO
National Provider Identifier
1265630784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9407
- Practice address
- 2373 Central Park Blvd Unit 305
Denver, CO 80238-2301 - Phone
- (206) 228-2173
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 9407 | CO | Primary |
| Pediatric Dentistry | 1223P0221X | DE00009700 | WA |
Addresses
Primary practice location
2373 Central Park Blvd Unit 305
Denver, CO 80238-2301
Mailing address
2580 17TH St Unit 207
Denver, CO 80211-6411
Phone (206) 228-2173
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 |
|---|---|---|---|
| DE00009700 | WA | MD | Pediatric Dentist |
| 9407 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1265630784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2580 17TH ST UNIT 207",
"city": "DENVER",
"state": "CO",
"postal_code": "802116411",
"telephone_number": "206-228-2173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2373 CENTRAL PARK BLVD UNIT 305",
"city": "DENVER",
"state": "CO",
"postal_code": "802382301",
"telephone_number": "206-228-2173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "ALFAIYAZ",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-05",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "9407",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE00009700",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.