Seyed Hamed Mirzamani, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.032576 Issued in IL

Practice address

223 E Il-38
Rochelle, IL 61068

Phone

(815) 561-6058

NPI assigned

May 26, 2020

Sex

Male

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1457974354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600560463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E IL-38",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "61068",
            "telephone_number": "815-561-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZAMANI",
        "first_name": "SEYED",
        "middle_name": "HAMED",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-26",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Meyers, L.M.T.
• Kourtnee Jo Mezo
• Michael J. Monfils, M.D., L.L.C.
• Midwest Physical Therapy
• Payton Mifflin
• Mlsna Family Eye Care SC (Rochelle Eye Care Center)
• Reid E Mlsna, OD
• Michael J. Monfils, M.D.
• Christopher Howard Mrofcza
• Rebecca Munson

• Dentist in Rochelle, IL
• Providers in Rochelle, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.

Verify at the official NPI Registry.