Ameenuddin Syed Ahmed

Primary specialty

DentistTaxonomy code 122300000X

License

019.033605 Issued in IL

Practice address

142 S Gary Ave Ste 102
Bloomingdale, IL 60108-2226

Phone

(630) 283-0652

NPI assigned

Jun 13, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Edp of Illinois P.C

  • Dental Clinic/Center
  • Dupo, IL
  • NPI 1154712784
  NPD (past)
• Steven W. Long DDS PC

  • General Practice Dentistry
  • St Charles, IL
  • NPI 1992804611
  NPD (past)

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1689304602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 S GARY AVE STE 102",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S GARY AVE STE 102",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082226",
            "telephone_number": "630-283-0652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40W177 Campton Xing Dr",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601756582",
            "country_code": "US",
            "telephone_number": "630-443-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "AMEENUDDIN",
        "middle_name": "SYED",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61427701",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aesthetic Dental LLC
• Affiliated Clinical Psychologists
• Affiliated Clinical Psychologists Limited
• Ag SLP
• Ziauddin Ahmad
• Aziz Ahmed, M.D.
• Nazneen Ahmed, MD
• Wahaj Ahmed, M.D.
• Ajm Counseling LLC
• Zainab Ajmeri

• All providers in Bloomingdale, IL
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.