Ayan Mohyidin Dhore I

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

056949-9 Issued in MN

Practice address

17162 New Market Dr
Eden Prairie, MN 55347-5331

Phone

(952) 686-8491

NPI assigned

Dec 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shining Angels Care LLC

  • Home Health Registered Nurse
  • Eden Prairie, MN
  • NPI 1083482806
  NPD Authorized official

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1386880490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17162 NEW MARKET DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553475331",
            "telephone_number": "952-686-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17162 NEW MARKET DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553475331",
            "telephone_number": "952-686-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHORE",
        "first_name": "AYAN",
        "middle_name": "MOHYIDIN",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "056949-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dentists of Eden Prairie, PC
• Madeleine Grace Derbis
• Robert E Derr, DDS
• Chelsea Devoir, M.ED, BCBA
• Brandi Kaye Dewitt
• Diagnostic Imaging of South Jersey PC
• Diamond Care LLC
• Aileen Diaz Cruseno
• Kirk Alan Dickey, DDS
• James Jerome Diehl, M.D.

• Registered Nurse in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.