Active NPI
Andrew James Majeran, D.M.D.
- General Practice Dentistry
- Clive, IA
National Provider Identifier
1508093857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 08712
- Practice address
- 1620 NW 114TH St
Clive, IA 50325-7071 - Phone
- (515) 287-2006
- NPI assigned
- Jun 14, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 08712 | IA | Primary |
Addresses
Primary practice location
1620 NW 114TH St
Clive, IA 50325-7071
Mailing address
1620 NW 114TH St
Clive, IA 50325-7071
Phone (515) 287-2006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508093857 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08712 | IA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1508093857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 NW 114TH ST",
"city": "CLIVE",
"state": "IA",
"postal_code": "503257071",
"telephone_number": "515-287-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 NW 114TH ST",
"city": "CLIVE",
"state": "IA",
"postal_code": "503257071",
"telephone_number": "515-287-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJERAN",
"first_name": "ANDREW",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-14",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "08712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508093857",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.