Individual provider Active NPI

Negar Massah

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1780107052
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6438 Issued in AL
Practice address
2850 Venice Rd
Apt 1135
Birmingham, AL 35211
Phone
(757) 681-3335
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6438 AL
General Practice Dentistry 1223G0001X 6438 AL Primary

Addresses

Primary practice location

2850 Venice Rd
Apt 1135
Birmingham, AL 35211

Mailing address

230 E 10TH St Ste 106
Anniston, AL 36207-5771
Phone (256) 741-7340

Other practice location 1

230 E 10th St Ste 106
Anniston, AL 36207-5771
Phone (256) 741-7340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20171025001175 AL Order and Referring Only - DentistPractitioner - Dentist 5294001905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6438ALMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780107052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 10TH ST STE 106",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075771",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 VENICE RD",
            "address_2": "APT 1135",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35211",
            "telephone_number": "757-681-3335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 E 10th St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Anniston",
            "state": "AL",
            "postal_code": "362075771",
            "country_code": "US",
            "telephone_number": "256-741-7340",
            "fax_number": "256-741-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSAH",
        "first_name": "NEGAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6438",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.