Individual provider Active NPI

Muhammad Naveed Ayyubi, DDS

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1710032552
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58992 Issued in CA
Practice address
4120 Dale Rd Ste J6
Modesto, CA 95356-9239
Phone
(209) 543-9999
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58992 CA Primary
General Practice Dentistry 1223G0001X D12302 MN

Addresses

Primary practice location

4120 Dale Rd Ste J6
Modesto, CA 95356-9239

Mailing address

4120 Dale Rd Ste J6
Modesto, CA 95356-9239
Phone (209) 543-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D12302MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
M N Ayyubi DDS Inc PastSince Feb 1, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1710032552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 DALE RD STE J6",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569239",
            "telephone_number": "209-543-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 DALE RD STE J6",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569239",
            "telephone_number": "209-543-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYUBI",
        "first_name": "MUHAMMAD",
        "middle_name": "NAVEED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58992",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.