Individual provider Active NPI

Rahman Ullah, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Worchester, MA
National Provider Identifier
1912173196
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN22086 Issued in MA
Practice address
Park Ave Dental Center
456 Park Avenue
Worchester, MA 01610
Phone
(508) 799-4555
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22086 MA
General Practice Dentistry 1223G0001X P58401 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN22086 MA Primary

Addresses

Primary practice location

Park Ave Dental Center
456 Park Avenue
Worchester, MA 01610

Mailing address

63 Sherman St
Canton, MA 02021-2225
Phone (617) 462-0116

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
22086MAMDDentist
P58401NYMDGeneral Practice Dentistry
DN22086MAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1912173196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SHERMAN ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212225",
            "telephone_number": "617-462-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARK AVE DENTAL CENTER",
            "address_2": "456 PARK AVENUE",
            "city": "WORCHESTER",
            "state": "MA",
            "postal_code": "01610",
            "telephone_number": "508-799-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLAH",
        "first_name": "RAHMAN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "22086",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "P58401",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN22086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.