Individual provider Active NPI

Ozair Mohammed Ferozuddin, DMD

  • Dentist
  • Anaheim, CA
National Provider Identifier
1376276709
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109164 Issued in CA
Practice address
505 S Villa Real Ste 101B
Anaheim, CA 92807-3432
Phone
(714) 974-4332
NPI assigned
Jul 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.033814 IL
Dentist 122300000X 109164 CA Primary

Addresses

Primary practice location

505 S Villa Real Ste 101B
Anaheim, CA 92807-3432

Mailing address

14765 Maplewood Dr
Chino Hills, CA 91709-5186
Phone (714) 612-4930

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
I20240201001362 CA Order and Referring Only - DentistPractitioner - Dentist 9638522089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109164CAMDDentist
019.033814ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Raihan Nazir DDS, Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

505 S Villa Real
Ste 101B
Anaheim, CA 92807
Phone (714) 974-4332

Organizations & group practices 1

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": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1376276709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14765 MAPLEWOOD DR",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095186",
            "telephone_number": "714-612-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VILLA REAL STE 101B",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073432",
            "telephone_number": "714-974-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEROZUDDIN",
        "first_name": "OZAIR",
        "middle_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-04",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033814",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.