Dzheikhuna Mamedova

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

061231 Issued in NY

Practice address

82 Holland St
Rochester, NY 14605-2199

Phone

(585) 423-5800

Fax

(585) 423-2890

NPI assigned

Jul 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1952953945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 HOLLAND ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052199",
            "telephone_number": "585-423-5800",
            "fax_number": "585-423-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 HOLLAND ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146052199",
            "telephone_number": "585-423-5800",
            "fax_number": "585-423-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMEDOVA",
        "first_name": "DZHEIKHUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Maloney, M.D.
• Kamil Malshy, MD
• Taylor Malta, AGNP-C
• Rajasekhar Srinivasa Rama Malyala, M.D.
• Mama Manatee LLC
• Bilal Mammah, DMD
• Manoj Jacob Mammen, M.D.
• Mammography of the University of Rochester
• Soyon Mamo, PHARM.D
• Li-Xing Man, M.D.

• General Practice Dentistry in Rochester, NY
• Providers in Rochester, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.