Active NPI
Amruta Mahajan
- Endodontics
- Warren, MI
National Provider Identifier
1427598598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 2901022145
- Practice address
- 2425 E 12 Mile Rd
Warren, MI 48092-5667 - Phone
- (586) 573-7334
- NPI assigned
- Mar 8, 2017
- Last updated
- Mar 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 2901022145 | MI | Primary |
Addresses
Primary practice location
2425 E 12 Mile Rd
Warren, MI 48092-5667
Mailing address
1327 S Main St
Royal Oak, MI 48067-3267
Phone (615) 957-7554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200130003247 | MI | Order and Referring Only - Dentist | 2567898034 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022145 | MI | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488931200000",
"number": "1427598598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1327 S MAIN ST",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480673267",
"telephone_number": "615-957-7554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 E 12 MILE RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480925667",
"telephone_number": "586-573-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAJAN",
"first_name": "AMRUTA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-08",
"last_updated": "2017-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "2901022145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.