Individual provider Active NPI

Nada Mir Iftekhar

  • Dentist
  • Cleveland, OH
National Provider Identifier
1720833643
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
RES004730 Issued in OH
Practice address
4071 Lee Rd Ste 260
Cleveland, OH 44128-2173
Phone
(216) 727-0234
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES004730 OH Primary

Addresses

Primary practice location

4071 Lee Rd Ste 260
Cleveland, OH 44128-2173

Mailing address

4071 Lee Rd Ste 260
Cleveland, OH 44128-2173
Phone (216) 727-0234

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
RES004730OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1720833643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 LEE RD STE 260",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441282173",
            "telephone_number": "216-727-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 LEE RD STE 260",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441282173",
            "telephone_number": "216-727-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFTEKHAR",
        "first_name": "NADA",
        "middle_name": "MIR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES004730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.