Individual provider Active NPI

Ghazwan Ghazi, DMD

  • Periodontics
  • Canton, MA
National Provider Identifier
1659443869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
18265 Issued in MA
Practice address
608 Washington St
Canton, MA 02021-3032
Phone
(781) 828-1788
Fax
(781) 828-2788
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 18265 MA Primary

Addresses

Primary practice location

608 Washington St
Canton, MA 02021-3032

Mailing address

608 Washington St
Canton, MA 02021-3032
Phone (781) 828-1788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180522000020 MA Practitioner - Oral Surgery 0840582268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18265MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chelmsford Dental Group PC Current Accepting new patients
Canton Dental Group Past Accepting new patients

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659443869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020213032",
            "telephone_number": "781-828-1788",
            "fax_number": "781-828-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020213032",
            "telephone_number": "781-828-1788",
            "fax_number": "781-828-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAZI",
        "first_name": "GHAZWAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "18265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.