Individual provider Active NPI

Arrash Ahmadnia, DDS

  • Dentist
  • Springfield, MO
National Provider Identifier
1891704193
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2006012741 Issued in MO
Practice address
1701 W Sunshine Suite Q
Springfield, MO 65807-2261
Phone
(417) 501-1048
Fax
(417) 501-1661
NPI assigned
Aug 5, 2006
Last updated
Aug 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2006012741 MO Primary

Addresses

Primary practice location

1701 W Sunshine Suite Q
Springfield, MO 65807-2261

Mailing address

1701 W Sunshine Suite Q
Springfield, MO 65807-2261
Phone (417) 501-1048

Other identifiers 1

IdentifierTypeStateIssuer
400984001MedicaidMO

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
2006012741MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Dental Services LP Past Accepting new patients
Access Dental Services LP PastSince May 22, 2022 Accepting new patients
Access Dental Services LP Past Accepting new patients

Organizations & group practices 3

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1891704193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W SUNSHINE SUITE Q",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072261",
            "telephone_number": "417-501-1048",
            "fax_number": "417-501-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W SUNSHINE SUITE Q",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658072261",
            "telephone_number": "417-501-1048",
            "fax_number": "417-501-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADNIA",
        "first_name": "ARRASH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2006012741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400984001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.