Nipun Mahajan, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

D012458 Issued in AZ

Practice address

1441 N 12TH St
Phoenix, AZ 85006-2837

Phone

(602) 521-5150

NPI assigned

Sep 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: nipun.mahajan@bannerhealth.com

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.

• Watanabe Rocksprings Dental Group, PC

  • General Practice Dentistry
  • Las Vegas, NV
  • NPI 1508906504
  NPD (past)

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1699325985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 S CIMARRON RD # 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132135",
            "telephone_number": "415-792-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "NIPUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-18",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "D012458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nipun.mahajan@bannerhealth.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1441 N 12th St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850062837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Chen Mah, PHARMD
• Emelhussein Siddig Mahadi
• Sydney A. Mahaffay, CRNA
• Beverly Sue Mahaffey, L.P.C.
• Mahmoud Mahafzah, M.D
• Pushpa Mahalingam, MD
• Amanda L Mahan, LPC
• George Budd Mahan, PHARM.D.
• Padma R Mahant, M.D.
• Giyth Mithim Mahdi, MD

• Oral & Maxillofacial Surgery (D.M.D.) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.