Active NPI
Amatullah Mamajiwala
- Dentist
- Temple, TX
National Provider Identifier
1447035753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39960
- Practice address
- 3108 S 31St St Unit 3108
Temple, TX 76502-1803 - Phone
- (254) 267-2240
- NPI assigned
- Aug 28, 2023
- 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 | 39960 | TX | Primary |
Addresses
Primary practice location
3108 S 31St St Unit 3108
Temple, TX 76502-1803
Mailing address
1124 W Avenue O Apt 1204
Belton, TX 76513-4676
Phone (313) 804-1261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20250815000572 | TX | Order and Referring Only - Dentist | 6507365780 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39960 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1447035753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 W AVENUE O APT 1204",
"city": "BELTON",
"state": "TX",
"postal_code": "765134676",
"telephone_number": "313-804-1261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3108 S 31ST ST UNIT 3108",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765021803",
"telephone_number": "254-267-2240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMAJIWALA",
"first_name": "AMATULLAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "39960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.