Individual provider Active NPI

Amir Dehghan, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Aurora, CO
National Provider Identifier
1295079747
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
61094 Issued in CA
Practice address
2101 N Ursula St Unit 401
Aurora, CO 80045-7423
Phone
(310) 710-6527
NPI assigned
Nov 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 61094 CA Primary
Dentist 122300000X 00201888 CO

Addresses

Primary practice location

2101 N Ursula St Unit 401
Aurora, CO 80045-7423

Mailing address

2101 N Ursula St Unit 401
Aurora, CO 80045-7423
Phone (310) 710-6527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151020000077 CA Order and Referring Only - DentistPractitioner - Dentist 0143539890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
00201888COMDDentist
61094CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1353542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1295079747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N URSULA ST UNIT 401",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457423",
            "telephone_number": "310-710-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N URSULA ST UNIT 401",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457423",
            "telephone_number": "310-710-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHGHAN",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-22",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "61094",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00201888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.