Individual provider Active NPI

Ayesha Muzaffar, DDS

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1386997377
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039375 Issued in PA
Practice address
1851 Christopher Columbus Blvd
Philadelphia, PA 19148-2800
Phone
(215) 755-2559
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS039375 PA Primary

Addresses

Primary practice location

1851 Christopher Columbus Blvd
Philadelphia, PA 19148-2800

Mailing address

1851 Christopher Columbus Blvd
Philadelphia, PA 19148-2800
Phone (215) 755-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230105000718 NJ Order and Referring Only - DentistPractitioner - Dentist 0749650976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS039375PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1386997377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 CHRISTOPHER COLUMBUS BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482800",
            "telephone_number": "215-755-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 CHRISTOPHER COLUMBUS BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482800",
            "telephone_number": "215-755-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUZAFFAR",
        "first_name": "AYESHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.