Individual provider Active NPI

Usman Sibtain Fazli, DMD

  • General Practice Dentistry
  • Cranston, RI
National Provider Identifier
1497838106
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN02946 Issued in RI
Practice address
1090 Cranston St
Cranston, RI 02920-7323
Phone
(401) 943-1981
Fax
(401) 943-2846
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN02946 RI Primary

Addresses

Primary practice location

1090 Cranston St
Cranston, RI 02920-7323

Mailing address

311 Doric Ave
Cranston, RI 02910-2903
Phone (401) 467-9610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20180419001680 MA Order and Referring Only - DentistPractitioner - Dentist 6103826060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN02946RIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497838106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-467-9610",
            "fax_number": "401-467-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 CRANSTON ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207323",
            "telephone_number": "401-943-1981",
            "fax_number": "401-943-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZLI",
        "first_name": "USMAN",
        "middle_name": "SIBTAIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.