Active NPI
Fakhrulhasan Kaleemi Syed Mohammed, DDS
- Dentist
- Worcester, MA
National Provider Identifier
1932969045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DF100018
- Practice address
- 150 Goddard Memorial Dr Ste 2
Worcester, MA 01603-1260 - Phone
- (508) 796-1555
- NPI assigned
- Mar 19, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DF100018 | MA | Primary |
Addresses
Primary practice location
150 Goddard Memorial Dr Ste 2
Worcester, MA 01603-1260
Mailing address
150 Goddard Memorial Dr Ste 2
Worcester, MA 01603-1260
Phone (508) 796-1555
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
| License | State | Type | Specialty |
|---|---|---|---|
| DF100018 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1932969045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 GODDARD MEMORIAL DR STE 2",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031260",
"telephone_number": "508-796-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GODDARD MEMORIAL DR STE 2",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031260",
"telephone_number": "508-796-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYED MOHAMMED",
"first_name": "FAKHRULHASAN KALEEMI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-19",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DF100018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.