Individual provider Active NPI

Nasreen Fuad a Akbar, B.D.S

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1619539889
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2952000836 Issued in MI
Practice address
2700 Martin Luther King Jr. Blvd
Detroit, MI 48208
Phone
(313) 494-6611
Fax
(617) 636-0310
NPI assigned
Jul 8, 2019
Reactivated
Oct 5, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 2952000836 MI Primary

Addresses

Primary practice location

2700 Martin Luther King Jr. Blvd
Detroit, MI 48208

Mailing address

2700 Martin Luther King Jr. Blvd
Detroit, MI 48208
Phone (313) 494-6611

Other identifiers 2

IdentifierTypeStateIssuer
2952000836OtherMIDENTAL LICENSE
5315244562OtherMICONTROLLED SUBSTANCE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2952000836MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1619539889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR. BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48208",
            "telephone_number": "313-494-6611",
            "fax_number": "617-636-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR. BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48208",
            "telephone_number": "313-494-6611",
            "fax_number": "617-636-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKBAR",
        "first_name": "NASREEN",
        "middle_name": "FUAD A",
        "name_prefix": "Ms.",
        "credential": "B.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "deactivation_date": "2020-02-17",
        "reactivation_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2952000836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "2952000836",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315244562",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.