Amjad Nazzal, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

1001063-15 Issued in WI

Practice address

2971 Chapel Valley Rd
Fitchburg, WI 53711

Phone

(608) 443-4940

NPI assigned

Jun 6, 2012

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 WI

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

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.

• Pediatric Dental Specialists of Madison LLC

  • Dentist
  • Madison, WI
  • NPI 1437310604
  NPD (past)
• Periodontal & Implant Specialists of Madison, LLC

  • Dentist
  • Madison, WI
  • NPI 1366614885
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1487915484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2971 CHAPEL VALLEY RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117420",
            "telephone_number": "213-271-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 CHAPEL VALLEY RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "53711",
            "telephone_number": "608-443-4940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2343 Scarff St",
            "address_2": "#104",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900071964",
            "country_code": "US",
            "telephone_number": "213-271-4720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49 N Walbridge Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537143506",
            "country_code": "US",
            "telephone_number": "608-443-1778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZZAL",
        "first_name": "AMJAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "1001063-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne E Musser Jr., MD
• My Next Step
• Laura Nagel, MS, OTR/L
• Jenna Napierala-Simonsen, M.A. CCC-SLP
• Kristin Naylor
• Jacalyn A Nelson, MD
• Kaleb Nelson, LCSW
• Kelly Nest, PHARMD, RPH
• Holly Annette Neuman, MS, MFT
• Christopher S. Nevers, D.O.

• Periodontics in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.