NPIMap

Individual provider Active NPI

Mohammed Mushtaq Ahmed

  • Dentist
  • Melbourne, FL
National Provider Identifier
1629452545
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN21406 Issued in FL
Practice address
7827 N Wickham Rd
Suite a
Melbourne, FL 32940-8289
Phone
(321) 434-4444
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21406 FL Primary

Addresses

Primary practice location

7827 N Wickham Rd
Suite a
Melbourne, FL 32940-8289

Mailing address

7827 N Wickham Rd
Suite a
Melbourne, FL 32940-8289
Phone (321) 434-4444

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
DN21406FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
New Image Dentistry Dentist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1629452545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7827 N WICKHAM RD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408289",
            "telephone_number": "321-434-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7827 N WICKHAM RD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408289",
            "telephone_number": "321-434-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOHAMMED",
        "middle_name": "MUSHTAQ",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.