NPIMap

Individual provider Active NPI

Ahmad A Beydoun, DDS

  • Dentist
  • Dearborn, MI
National Provider Identifier
1972611028
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29-01-016362 Issued in MI
Practice address
10033 Vernor Hwy
Dearborn, MI 48120-1513
Phone
(313) 843-6530
Fax
(313) 843-1410
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29-01-016362 MI Primary

Addresses

Primary practice location

10033 Vernor Hwy
Dearborn, MI 48120-1513

Mailing address

10033 Vernor Hwy
Dearborn, MI 48120-1513
Phone (313) 843-6530

Other identifiers 1

IdentifierTypeStateIssuer
4881109MedicaidMI

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vernor Dental, P.C. Dentist Past Accepting new patients
Dr Ahmad a. Beydoun DDS , PC Past Accepting new patients

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972611028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10033 VERNOR HWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201513",
            "telephone_number": "313-843-6530",
            "fax_number": "313-843-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10033 VERNOR HWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201513",
            "telephone_number": "313-843-6530",
            "fax_number": "313-843-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "AHMAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "29-01-016362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4881109",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.