Ahmad-Reza Noroozi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901019937 Issued in MI

Practice address

306 N Gould St
Owosso, MI 48867-2417

Phone

(989) 723-3882

NPI assigned

Aug 19, 2008

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 MI

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

Practice roles

Locations

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.

• Great Lakes Oral Surgery and Implants, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Flint, MI
  • NPI 1902993819
  Medicare reassignment NPD
• Gmos Oral Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Flint, MI
  • NPI 1194675223
  NPD (past)

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1467609719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5417 GATEWAY CTR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073980",
            "telephone_number": "810-424-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N GOULD ST",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672417",
            "telephone_number": "989-723-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOROOZI",
        "first_name": "AHMAD-REZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901019937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Nichols
• Paige Nichols
• Roger Paul Nichols
• Levi Alexander Nixon
• Shadoe S Nolph
• North Street Medical Center P C
• Dustin G Nowacek, MD
• Kylie O'Brien
• Katie Louise O'Dell
• Patrick J O'Hara

• Oral and Maxillofacial Surgery (Dentist) in Owosso, MI
• Providers in Owosso, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.