Ayman Ghozlan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46060 Issued in CA

Practice address

1745 W Kettleman LN
B
Lodi, CA 95242-9287

Phone

(916) 337-1077

Fax

(916) 897-2567

NPI assigned

Feb 8, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ghozlan Dental Corp.

  • Dental Clinic/Center
  • Lodi, CA
  • NPI 1447430624
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1740320480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10374 STATHOS DR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571609",
            "telephone_number": "916-337-1077",
            "fax_number": "916-897-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W KETTLEMAN LN",
            "address_2": "B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952429287",
            "telephone_number": "916-337-1077",
            "fax_number": "916-897-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOZLAN",
        "first_name": "AYMAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D46060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genxan Transport LLC
• James Douglas Gerard, D.C
• Fatema Manekia Ghani, DPT
• Mobin P Ghavami, M.D.
• Ghozlan Dental Corp.
• Phuong Thu Giao, DDS
• Shana M Gibbons, RN
• Norielyn Gier
• Donna L Gilbert
• Gill and Patel Dental Corporation

• General Practice Dentistry in Lodi, CA
• Providers in Lodi, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.