Nawar Taqi

Primary specialty

DentistTaxonomy code 122300000X

License

2901601323 Issued in MI

Practice address

1074 Jackson Xing
Jackson, MI 49202-2039

Phone

(630) 715-3734

NPI assigned

Jun 6, 2022

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1285363374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 CHERRY BLOSSOM DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974004",
            "telephone_number": "630-715-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 JACKSON XING",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022039",
            "telephone_number": "630-715-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAQI",
        "first_name": "NAWAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601323APP22",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1074 Jackson Xing",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492022039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dentist in Jackson, MI
• Providers in Jackson, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.