Ayesha Naureen Zahurullah, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61100291 Issued in WA

Practice address

10011 Bridgeport Way SW Ste 700
Lakewood, WA 98499-2350

Phone

(253) 215-1101

NPI assigned

Apr 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1558687293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MERIDIAN AVE E APT M208",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983711088",
            "telephone_number": "248-790-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 BRIDGEPORT WAY SW STE 700",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992350",
            "telephone_number": "253-215-1101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4642 S Damen Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606094043",
            "country_code": "US",
            "telephone_number": "773-869-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAHURULLAH",
        "first_name": "AYESHA",
        "middle_name": "NAUREEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020106",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028228",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61100291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen HB Yu, M.D.
• Vicky Yu, MD
• Christopher Yuen, DPT
• Mi Eun Yun
• Mikhail A Zagorenko
• Alexis Antonia Zamarron-Priebe, LMT
• Angela L Zamarron, OTR/L
• Sarah Kathleen Zanders, BA
• Zachary Zebruck
• Thomas Zellner

• General Practice Dentistry in Lakewood, WA
• Providers in Lakewood, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.