Individual provider Active NPI

Aziz Rasulov, DDS

  • General Practice Dentistry
  • Thornton, CO
National Provider Identifier
1508943085
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN-8771 Issued in CO
Practice address
550 E Thornton Pkwy
#240-A
Thornton, CO 80229-2100
Phone
(303) 280-8878
NPI assigned
Nov 1, 2006
Last updated
Oct 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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 DEN-8771 CO Primary

Addresses

Primary practice location

550 E Thornton Pkwy
#240-A
Thornton, CO 80229-2100

Mailing address

14025 E Exposition Ave
Suite 810
Aurora, CO 80012-2522
Phone (303) 340-0422

Other identifiers 2

IdentifierTypeStateIssuer
1777418OtherCOUNITED CONCORDIA
43475361MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20161017000619 CO Order and Referring Only - DentistPractitioner - Dentist 4789972241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN-8771COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Thornton Youth Dentistry, PC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1508943085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14025 E EXPOSITION AVE",
            "address_2": "SUITE 810",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122522",
            "telephone_number": "303-340-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E THORNTON PKWY",
            "address_2": "#240-A",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292100",
            "telephone_number": "303-280-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASULOV",
        "first_name": "AZIZ",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-8771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1777418",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43475361",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.