Individual provider Active NPI

Mitul Ahmed, DMD

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1548044365
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.028338 Issued in OH
Practice address
3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399
Phone
(513) 898-1194
NPI assigned
Aug 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11008 KY
General Practice Dentistry 1223G0001X 30.028338 OH Primary

Addresses

Primary practice location

3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399

Mailing address

2915 Woodburn Ave Unit O
Cincinnati, OH 45206-1487
Phone (646) 641-7846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016002693 OH Order and Referring Only - DentistPractitioner - Dentist 8426403114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11008KYMDGeneral Practice Dentistry
30.028338OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists at Hyde Park Plaza, PC, Inc PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1548044365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 WOODBURN AVE UNIT O",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061487",
            "telephone_number": "646-641-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 PAXTON AVE STE 12A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092399",
            "telephone_number": "513-898-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MITUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11008",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.028338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.