Individual provider Active NPI

Javeria Mirza, DMD

  • General Practice Dentistry
  • Greensboro, NC
National Provider Identifier
1629309794
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10520 Issued in NC
Practice address
1331 N Elm St Ste 102
Greensboro, NC 27401-6303
Phone
(336) 378-9630
Fax
(336) 370-9608
NPI assigned
Jan 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DIO2431400 NJ
General Practice Dentistry 1223G0001X 0401412865 VA
General Practice Dentistry 1223G0001X 10520 NC Primary

Addresses

Primary practice location

1331 N Elm St Ste 102
Greensboro, NC 27401-6303

Mailing address

1331 N Elm St Ste 102
Greensboro, NC 27401-6303
Phone (336) 378-9630

Other practice location 1

1331 N Elm St Ste 102
Greensboro, NC 27401-6303
Phone (336) 378-9630

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
10520NCMDMental Health Counselor
22DIO2431400NJMDGeneral Practice Dentistry
0401412865VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David N, Taylor, D.D.S. General Practice PastSince Apr 20, 2021 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": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1629309794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 102",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016303",
            "telephone_number": "336-378-9630",
            "fax_number": "336-370-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 N ELM ST STE 102",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016303",
            "telephone_number": "336-378-9630",
            "fax_number": "336-370-9608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 N Elm St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274016303",
            "country_code": "US",
            "telephone_number": "336-378-9630",
            "fax_number": "336-370-9608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "JAVERIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DIO2431400",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412865",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.