Individual provider Active NPI

Andrew A Afshar, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Midland, MI
National Provider Identifier
1659314888
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
2901022525 Issued in MI
Practice address
6112 Merlin CT
Midland, MI 48640-7358
Phone
(989) 839-9979
Fax
(989) 839-9553
NPI assigned
Jun 14, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1946 ND
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 2901022525 MI Primary

Addresses

Primary practice location

6112 Merlin CT
Midland, MI 48640-7358

Mailing address

6112 Merlin CT
Midland, MI 48640-7358
Phone (989) 839-9979

Other practice location 1

1140 W Capitol Ave
Bismarck, ND 58501-9956
Phone (701) 258-7220

Other practice location 2

31099 Chagrin Blvd Ste 100
Pepper Pike, OH 44124-5959
Phone (216) 450-5888

Other identifiers 2

IdentifierTypeStateIssuer
1946OtherNDDENTAL LICENSE
41322MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20201009001979 MI Practitioner - Oral Surgery 4082899828 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2901022525MIMDOral & Maxillofacial Surgery (D.M.D.)
1946NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Oral & Maxillofacial Surgery P.C. Oral and Maxillofacial Surgery CurrentSince Nov 1, 2020 Accepting new patients
Face & Jaw Surgeons, PC Oral and Maxillofacial Surgery PastSince Jan 1, 2012 Accepting new patients

Locations

6112 Merlin Ct
Midland, MI 48640
Phone (989) 839-5833

Organizations & group practices 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659314888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407358",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407358",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 W CAPITOL AVE",
            "address_purpose": "LOCATION",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585019956",
            "country_code": "US",
            "telephone_number": "701-258-7220",
            "fax_number": "701-222-2329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31099 Chagrin Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pepper Pike",
            "state": "OH",
            "postal_code": "441245959",
            "country_code": "US",
            "telephone_number": "216-450-5888",
            "fax_number": "216-450-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AFSHAR",
        "first_name": "ANDREW",
        "middle_name": "A",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ND",
            "license": "1946",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901022525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "1946",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41322",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.