Bassam Kinaia, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901017676 Issued in MI

Practice address

3801 Metropolitan Pkwy
Sterling Heights, MI 48310-3710

Phone

(586) 275-7667

Fax

(586) 275-7872

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Khalil & Kinaia D.D.S.,P.C.

  • General Practice Dentistry
  • Flint, MI
  • NPI 1912157199
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1023160041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103710",
            "telephone_number": "586-275-7667",
            "fax_number": "586-275-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103710",
            "telephone_number": "586-275-7667",
            "fax_number": "586-275-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINAIA",
        "first_name": "BASSAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17676",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901017676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01",
            "identifier": "463306091",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4469514",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Kim
• Euncho Kim
• Hyo S. Kim, M.D.
• Karmen D Kimmons
• Ban Kinaia, M.D.
• Renee Kinaia, NP
• Timberlynn Kincaid
• Kindered Heart Care LLC
• Kathy King
• Lilianna King

• Periodontics in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.