Individual provider Active NPI

Nilofar Mujtaba Jamasi, DMD

  • General Practice Dentistry
  • Kissimmee, FL
National Provider Identifier
1730254293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15455 Issued in FL
Practice address
3066 Michigan Ave
Kissimmee, FL 34744-1544
Phone
(407) 343-9800
Fax
(407) 876-9269
NPI assigned
Nov 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DN15455 FL Primary

Addresses

Primary practice location

3066 Michigan Ave
Kissimmee, FL 34744-1544

Mailing address

118 Sagecrest Dr
Ocoee, FL 34761-4601
Phone (407) 876-9269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161026003051 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8628356573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN15455FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Osceola Dental, Inc General Practice Past Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730254293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SAGECREST DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614601",
            "telephone_number": "407-876-9269",
            "fax_number": "407-876-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 MICHIGAN AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441544",
            "telephone_number": "407-343-9800",
            "fax_number": "407-876-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMASI",
        "first_name": "NILOFAR",
        "middle_name": "MUJTABA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.