Mohammed Moeeduddin Ahmed, BDS, MDS

Primary specialty

DentistTaxonomy code 122300000X

License

019.0134053 Issued in VT

Practice address

61 Pine St
Bristol, VT 05443-1043

Phone

(802) 453-3911

NPI assigned

Jun 14, 2022

Last updated

Aug 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mohd Moeeduddin Ahmed Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mahmed529349@direct.uvmhealth.org

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1871223792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GREENWICH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021202202",
            "telephone_number": "331-980-2703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 PINE ST",
            "city": "BRISTOL",
            "state": "VT",
            "postal_code": "054431043",
            "telephone_number": "802-453-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MOHAMMED",
        "middle_name": "MOEEDUDDIN",
        "name_prefix": "Dr.",
        "credential": "BDS, MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "019.0134053",
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "VT",
            "license": "019.0134053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6710467",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.redcloverfamilydentistry.org/contact",
            "affiliation": "N",
            "address_1": "61 Pine St",
            "city": "Bristol",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054431043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOHD",
            "last_name": "AHMED",
            "middle_name": "MOEEDUDDIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ac Dental Care, Inc. Dba Red Clover Family Dentistry
• Mary Colleen Anderson, DDS
• Brian D. Bates, MD
• Charles A Biss, LICSW
• Body and Mind Physical Therapy, PLC (Bristol Physical Therapy)
• Marian Ruth Bouchard, MD

• Dentist in Bristol, VT
• Providers in Bristol, VT by specialty
• Dentist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.