Active NPI
Ayesha Jeelani, DDS
- Dentist
- College Station, TX
National Provider Identifier
1386242527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36790
- Practice address
- 915 William D Fitch Pkwy Ste 300
College Station, TX 77845-4638 - Phone
- (440) 525-0847
- NPI assigned
- Oct 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36790 | TX | Primary |
Addresses
Primary practice location
915 William D Fitch Pkwy Ste 300
College Station, TX 77845-4638
Mailing address
915 William D Fitch Pkwy Ste 300
College Station, TX 77845-4638
Phone (440) 525-0847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36790 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602288000000",
"number": "1386242527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 WILLIAM D FITCH PKWY STE 300",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778454638",
"telephone_number": "440-525-0847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 WILLIAM D FITCH PKWY STE 300",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778454638",
"telephone_number": "440-525-0847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEELANI",
"first_name": "AYESHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-10",
"last_updated": "2020-10-10",
"certification_date": "2020-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.