DR. AHMAD DEEBAJAH - NPI NUMBER 1114210002

Summary

Provider Name: DR. AHMAD DEEBAJAH

NPI Number: 1114210002

Clasification: Dentist (122300000X)

Address:
3144 JOHN R RD
SUITE 100
TROY, MI
ZIP 48083

Phone Number: (248) 510-1100



Detailed Information

DR. Ahmad Deebajah is a dentist in Troy, MI. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. The assigned NPI number for this provider is 1114210002 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

3144 JOHN R RD
SUITE 100
TROY, MI
ZIP 48083-936
Phone: (248) 510-1100
Fax: (248) 251-0073

The enumeration date for this NPI number is 5/25/2011 and was last updated on 2/29/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 122300000X Dentist 2901020359 MI Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1114210002 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name DEEBAJAH The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name AHMAD The first name of the provider, if the provider is an individual.
5 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
6 Provider First Line Business Practice Location Address 3144 JOHN R RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Second Line Business Practice Location Address SUITE 100 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name TROY The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name MI The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 480835936 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 2485101100 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 2482510073 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 5/25/2011 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 2/29/2012 The date that a record was last updated or changed.
16 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 122300000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 2901020359 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 MI The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 2/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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