Individual provider Active NPI

Maryam Beyramian, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1700895075
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018133 Issued in MI
Practice address
3019 N 35TH Ave
109
Phoenix, AZ 85017-5206
Phone
(602) 269-7797
Fax
(602) 269-2329
NPI assigned
Aug 5, 2006
Last updated
Apr 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018133 MI Primary

Addresses

Primary practice location

3019 N 35TH Ave
109
Phoenix, AZ 85017-5206

Mailing address

3019 N 35TH Ave
109
Phoenix, AZ 85017-5206
Phone (602) 269-7797

Other identifiers 1

IdentifierTypeStateIssuer
020635027OtherMITAX IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170523002036 AZ Order and Referring Only - DentistPractitioner - Dentist 8628345816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901018133MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Westwinddental Downtown 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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208736000000",
    "number": "1700895075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 N 35TH AVE",
            "address_2": "109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175206",
            "telephone_number": "602-269-7797",
            "fax_number": "602-269-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 N 35TH AVE",
            "address_2": "109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175206",
            "telephone_number": "602-269-7797",
            "fax_number": "602-269-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYRAMIAN",
        "first_name": "MARYAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "020635027",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.