Individual provider Active NPI

Tara Firouzi, DDS

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1548820764
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19234150800 Issued in MI
Practice address
30801 Schoenherr Rd
Warren, MI 48088-6857
Phone
(313) 494-6907
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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 19234150800 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

30801 Schoenherr Rd
Warren, MI 48088-6857

Mailing address

1909 Fern St
Royal Oak, MI 48073-4185
Phone (212) 321-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190726001851 MI Order and Referring Only - DentistPractitioner - Dentist 7618203795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19234150800MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Firouzi Kazerani Dental Inc Current Accepting new patients

Locations

902 Woodside Rd
Redwood City, CA 94061
Phone (650) 365-8982

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1548820764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 FERN ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734185",
            "telephone_number": "212-321-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30801 SCHOENHERR RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886857",
            "telephone_number": "313-494-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIROUZI",
        "first_name": "TARA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "19234150800",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.