Reza Hamedy, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

S122 Issued in MN

Practice address

6411 Richfield Pkwy
Richfield, MN 55423-6400

Phone

(612) 869-3440

Fax

(612) 869-8297

NPI assigned

Jan 10, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Reza Hamedy Hamzeh Kolai Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Richfield Dentistry PC

  • General Practice Dentistry
  • Richfield, MN
  • NPI 1003231713
  NPD (past)

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1902342256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 VETERAN AVE APT 109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244833",
            "telephone_number": "310-310-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 RICHFIELD PKWY",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554236400",
            "telephone_number": "612-869-3440",
            "fax_number": "612-869-8297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMEDY",
        "first_name": "REZA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "S122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REZA",
            "last_name": "HAMEDY HAMZEH KOLAI",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Safiya A Hajihussein
• Christopher WH Hall, D.O.
• Justice Martinique Hall
• Rebecca Marie Hall, OTR/L
• Gabrielle Marie Hallahan
• Nanci L Hamlett, MA, LP
• Kerri Jobarnes Hammer, PA-C
• Nina Kae Hanevik, RN
• Julie Ann Meyer Hanks, R.N.
• Hannah Bunney, Ma, LPCC, LLC

• Endodontics in Richfield, MN
• Providers in Richfield, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.