Individual provider Active NPI

Ikram Abdulkerim Mahmood, DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clawson, MI
National Provider Identifier
1982871984
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2901013174 Issued in MI
Practice address
11 W Fourteen Mile Road
Suite 204
Clawson, MI 48017-3104
Phone
(248) 288-3579
Fax
(248) 288-3560
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2901013174 MI Primary

Addresses

Primary practice location

11 W Fourteen Mile Road
Suite 204
Clawson, MI 48017-3104

Mailing address

11 W Fourteen Mile Road
Suite 204
Clawson, MI 48017-3104
Phone (248) 288-3579

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2901013174MIMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1982871984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W FOURTEEN MILE ROAD",
            "address_2": "SUITE 204",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480173104",
            "telephone_number": "248-288-3579",
            "fax_number": "248-288-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 W FOURTEEN MILE ROAD",
            "address_2": "SUITE 204",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480173104",
            "telephone_number": "248-288-3579",
            "fax_number": "248-288-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "IKRAM",
        "middle_name": "ABDULKERIM",
        "name_prefix": "Mrs.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901013174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clawson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.