Individual provider Active NPI

Ali Maddahi, D.M.D.

  • General Practice Dentistry
  • Amherst, MA
National Provider Identifier
1942223243
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN20424 Issued in MA
Practice address
10 Rolling Green Dr
Amherst, MA 01002-2723
Phone
(978) 660-5711
Fax
(978) 665-5808
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20424 MA Primary

Addresses

Primary practice location

10 Rolling Green Dr
Amherst, MA 01002-2723

Mailing address

10 Rolling Green Dr
Amherst, MA 01002-2723
Phone (978) 660-5711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20150908001607 MA Practitioner - Oral Surgery 5092020784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Cambridge Public Health Commission CurrentSince Jan 14, 2014 Accepting new patients

Locations

1493 Cambridge St
#B13
Cambridge, MA 02139

119 Windsor St
Cambridge, MA 02139
Phone (617) 665-3600

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

Interoperability endpoints

  • Direct secure messaging: amaddahi55633@direct.challiance.masshiway.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1942223243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ROLLING GREEN DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022723",
            "telephone_number": "978-660-5711",
            "fax_number": "978-665-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ROLLING GREEN DR",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022723",
            "telephone_number": "978-660-5711",
            "fax_number": "978-665-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDAHI",
        "first_name": "ALI",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN20424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

Verify at the official NPI Registry.