NPIMap

Organization Active NPI

Irfan Aziz Khan Inc

Doing business as Grandview yard Polaris Dental Care

  • Dentist
  • Columbus, OH
National Provider Identifier
1285186932
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.022887 Issued in OH
Legal business name
IRFAN AZIZ KHAN INC
Doing business as
Grandview yard Polaris Dental Care
Practice address
885 W 3Rd Ave
Columbus, OH 43212-3106
Phone
(614) 505-7027
NPI assigned
Oct 28, 2016
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Jessica Bowersock
Title
Treatment Coordinator
Phone
(614) 505-7027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.022887 OH Primary

Addresses

Primary practice location

885 W 3Rd Ave
Columbus, OH 43212-3106

Mailing address

885 W 3Rd Ave
Columbus, OH 43212-3106

Other names 1

  • Grandview yard Polaris Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

885 W 3rd Ave
Columbus, OH 43212
Phone (614) 505-7027

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1285186932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 W 3RD AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 W 3RD AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123106",
            "telephone_number": "614-505-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRFAN AZIZ KHAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "BOWERSOCK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "614-505-7027"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.022887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandview yard Polaris Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.