Omar Alqushaibi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN30272 Issued in FL

Practice address

3639 S Orlando Dr # 1
Sanford, FL 32773-5611

Phone

(407) 360-5503

NPI assigned

Jul 10, 2025

Last updated

Jul 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1003707712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 PRESIDENTIAL BLVD APT 2823",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311733",
            "telephone_number": "407-360-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 S ORLANDO DR # 1",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735611",
            "telephone_number": "407-360-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALQUSHAIBI",
        "first_name": "OMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN30272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Sanford, FL
• Providers in Sanford, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.