Individual provider Active NPI

Ahmed Zaidi, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fresno, CA
National Provider Identifier
1811327935
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
102428 Issued in CA
Practice address
215 N Fresno St Ste 490
Fresno, CA 93701-2363
Phone
(559) 459-6114
NPI assigned
Nov 26, 2013
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 35041 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 102428 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

215 N Fresno St Ste 490
Fresno, CA 93701-2363

Mailing address

215 N Fresno St Ste 490
Fresno, CA 93701-2363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628003682 CA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 8123325420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102428CAMDMarriage & Family Therapist
35041TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Head and Neck Associates of Central California Oral and Maxillofacial Surgery CurrentSince Jul 1, 2023 Accepting new patients
TBHC Physician Services PC PastSince Aug 1, 2025 Accepting new patients

Locations

215 N Fresno St
Ste 490
Fresno, CA 93701
Phone (559) 459-4101

Organizations & group practices 2

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": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1811327935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N FRESNO ST STE 490",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N FRESNO ST STE 490",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012363",
            "telephone_number": "559-459-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAIDI",
        "first_name": "AHMED",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-26",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "35041",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "102428",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.