Active NPI
Khaleda Imroz
- General Practice Dentistry
- Montgomery, AL
National Provider Identifier
1598965899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5541
- Practice address
- 3439 McGehee Rd
Suite B
Montgomery, AL 36111-3392 - Phone
- (334) 288-1868
- NPI assigned
- Jul 24, 2007
- Sex
- Female
- 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 | 5541 | AL | Primary |
Addresses
Primary practice location
3439 McGehee Rd
Suite B
Montgomery, AL 36111-3392
Mailing address
415 N Grand Ave
Pueblo, CO 81003-3111
Phone (719) 562-4461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240521003200 | AL | Order and Referring Only - Dentist | 0648612770 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5541 | AL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1598965899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 N GRAND AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810033111",
"telephone_number": "719-562-4461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3439 MCGEHEE RD",
"address_2": "SUITE B",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361113392",
"telephone_number": "334-288-1868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMROZ",
"first_name": "KHALEDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "5541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.