Individual provider Active NPI

Shahram Navid

  • Dentist
  • Peabody, MA
National Provider Identifier
1881028975
Registry record updated Mar 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856383 Issued in MA
Practice address
210 Andover St
Peabody, MA 01960-1647
Phone
(978) 532-5550
Fax
(978) 532-8078
NPI assigned
Aug 26, 2013
Last updated
Mar 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856383 MA Primary

Addresses

Primary practice location

210 Andover St
Peabody, MA 01960-1647

Mailing address

210 Andover St
Peabody, MA 01960-1647
Phone (978) 532-5550

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
DN1856383MAMDDentist

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459036800000",
    "number": "1881028975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ANDOVER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601647",
            "telephone_number": "978-532-5550",
            "fax_number": "978-532-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ANDOVER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601647",
            "telephone_number": "978-532-5550",
            "fax_number": "978-532-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVID",
        "first_name": "SHAHRAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-26",
        "last_updated": "2016-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2016; 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.