Individual provider Active NPI

Sonia Saddaf Ahsan, D.D.S

  • Dentist
  • Prince Frederick, MD
National Provider Identifier
1861564882
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14336 Issued in MD
Practice address
205 Steeple Chase Dr
Ste. 208
Prince Frederick, MD 20678-4053
Phone
(413) 535-0296
NPI assigned
Nov 14, 2006
Last updated
Jun 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14336 MD Primary
Dentist 122300000X 21861 MA
Dentist 122300000X 0401412354 VA

Addresses

Primary practice location

205 Steeple Chase Dr
Ste. 208
Prince Frederick, MD 20678-4053

Mailing address

1508 Arcola CT
#5
Crofton, MD 21114-2701
Phone (410) 535-0296

Other names 1

  • Dr. Sonia Saddaf Gondal Former name

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
21861MAMDDentist
14336MDMDDentist
0401412354VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neibauer Dental Care, PC Past Accepting new patients

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1861564882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 ARCOLA CT",
            "address_2": "#5",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142701",
            "telephone_number": "410-535-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 STEEPLE CHASE DR",
            "address_2": "STE. 208",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784053",
            "telephone_number": "413-535-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHSAN",
        "first_name": "SONIA",
        "middle_name": "SADDAF",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14336",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21861",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONIA",
            "last_name": "GONDAL",
            "middle_name": "SADDAF",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.