Individual provider Active NPI

Amir Fereydouni, DMD

  • General Practice Dentistry
  • Littleton, CO
National Provider Identifier
1851364012
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8495 Issued in CO
Practice address
8199 Southpark LN
150
Littleton, CO 80120-5667
Phone
(303) 738-8828
Fax
(303) 738-8823
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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 8495 CO Primary

Addresses

Primary practice location

8199 Southpark LN
150
Littleton, CO 80120-5667

Mailing address

8199 Southpark LN
150
Littleton, CO 80120-5667
Phone (303) 738-8828

Other identifiers 1

IdentifierTypeStateIssuer
90323840MedicaidCO

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
8495COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1851364012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8199 SOUTHPARK LN",
            "address_2": "150",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205667",
            "telephone_number": "303-738-8828",
            "fax_number": "303-738-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8199 SOUTHPARK LN",
            "address_2": "150",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205667",
            "telephone_number": "303-738-8828",
            "fax_number": "303-738-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEREYDOUNI",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90323840",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.