Shadi Ghozati D.D.S. PA

Primary specialty

DentistTaxonomy code 122300000X

License

13298 Issued in MD

Legal business name

SHADI GHOZATI D.D.S. PA

Practice address

7226 Lee Deforest Dr
#208
Columbia, MD 21046-3239

Phone

(410) 872-0104

Fax

(410) 872-0105

NPI assigned

May 19, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Shadi Ghozati, D.D.SNPI 1578636510

Title

Dentis/ Owner

Phone

(410) 872-0104

Specialties & licenses 1

Addresses

Other names 1

• Columbia Gateway Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shadi Ghozati, D.D.S

  • General Practice Dentistry
  • Columbia, MD
  • NPI 1578636510
  NPD (past) Authorized official

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1508091687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7226 LEE DEFOREST DR",
            "address_2": "#208",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463239",
            "telephone_number": "410-872-0104",
            "fax_number": "410-872-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7226 LEE DEFOREST DR",
            "address_2": "#208",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463239",
            "telephone_number": "410-872-0104",
            "fax_number": "410-872-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADI GHOZATI D.D.S. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "GHOZATI",
        "authorized_official_first_name": "SHADI",
        "authorized_official_title_or_position": "DENTIS/ OWNER",
        "authorized_official_telephone_number": "410-872-0104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "13298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Gateway Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Starsha Sewell
• Zewdnesh Seyoum, MD
• Rawan Shaat
• Cleo Shackelford, RBT
• Jessica Shackman, M.D.
• Tahmineh Ann Shadkhoo, LCPC
• Amanda Louise Shafer, MSN, CRNP, FNP-C
• Jawedullah Shafiq
• Deepak A. Shah, MD
• Deshna Shah

• Dentist in Columbia, MD
• Providers in Columbia, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.