Individual provider Active NPI

Basem Al-Taani, BDS,DDS,

  • General Practice Dentistry
  • Dearborn, MI
National Provider Identifier
1033280789
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018142 Issued in MI
Practice address
18900 Michigan Ave
Sears Dental
Dearborn, MI 48126-3929
Phone
(313) 441-9226
Fax
(313) 441-9586
NPI assigned
Nov 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 2901018142 MI Primary

Addresses

Primary practice location

18900 Michigan Ave
Sears Dental
Dearborn, MI 48126-3929

Mailing address

5875 Landerbrook Dr Ste 250
Mayfield HTS, OH 44124-6502
Phone (800) 487-4867

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160610000696 MI Order and Referring Only - DentistPractitioner - Dentist 9436449030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901018142MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033280789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 LANDERBROOK DR STE 250",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441246502",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18900 MICHIGAN AVE",
            "address_2": "SEARS DENTAL",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263929",
            "telephone_number": "313-441-9226",
            "fax_number": "313-441-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-TAANI",
        "first_name": "BASEM",
        "name_prefix": "Dr.",
        "credential": "BDS,DDS,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.