Individual provider Active NPI

Nasir J Ahmed, D.D.S.

  • General Practice Dentistry
  • Elgin, IL
National Provider Identifier
1962494633
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS103542 Issued in CA
Practice address
1750 N Randall Rd
Suite # 270
Elgin, IL 60123-7900
Phone
(847) 888-0011
Fax
(847) 888-0022
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-022132 IL
General Practice Dentistry 1223G0001X DDS103542 CA Primary

Addresses

Primary practice location

1750 N Randall Rd
Suite # 270
Elgin, IL 60123-7900

Mailing address

1750 N Randall Rd
Suite # 270
Elgin, IL 60123-7900
Phone (847) 888-0011

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
DDS103542CAMDGeneral Practice Dentistry
019-022132ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Yun DDS PC PastSince Feb 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nasir.ahmed.p15@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 1

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1962494633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N RANDALL RD",
            "address_2": "SUITE # 270",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237900",
            "telephone_number": "847-888-0011",
            "fax_number": "847-888-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N RANDALL RD",
            "address_2": "SUITE # 270",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237900",
            "telephone_number": "847-888-0011",
            "fax_number": "847-888-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "NASIR",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-022132",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS103542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.