Individual provider Active NPI

Amir Salar Sarlak, DDS

  • Dentist
  • Columbia, MD
National Provider Identifier
1366534356
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13902 Issued in MD
Practice address
5667 Columbia Rd
Apt. 403
Columbia, MD 21044-1976
Phone
(443) 545-5501
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13902 MD Primary

Addresses

Primary practice location

5667 Columbia Rd
Apt. 403
Columbia, MD 21044-1976

Mailing address

10040 Baltimore National Pike
Ste E110
Ellicott City, MD 21042-3796
Phone (410) 750-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160218002208 MD Order and Referring Only - DentistPractitioner - Dentist 1850696444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13902MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sarlak, Honar & Associates, LLC Past Accepting new patients
Enchanted Medical LLC Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1366534356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10040 BALTIMORE NATIONAL PIKE",
            "address_2": "STE E110",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210423796",
            "telephone_number": "410-750-1022",
            "fax_number": "410-750-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 COLUMBIA RD",
            "address_2": "APT. 403",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441976",
            "telephone_number": "443-545-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARLAK",
        "first_name": "AMIR",
        "middle_name": "SALAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.