Active NPI
Amal Ganim Kthar
- Dentist
- Eastpointe, MI
National Provider Identifier
1043397920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017514
- Practice address
- 16555 East 10 Mile
Great Expression Dental Center Riviera Plaza
East Pointe, MI 48021 - Phone
- (586) 778-3838
- Fax
- (586) 778-3513
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017514 | MI | Primary |
Addresses
Primary practice location
16555 East 10 Mile
Great Expression Dental Center Riviera Plaza
East Pointe, MI 48021
Mailing address
16555 E 10 Mile Rd
Eastpointe, MI 48021-1192
Phone (586) 778-3838
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160205001840 | MI | Order and Referring Only - Oral Surgery | 6204130560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017514 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1043397920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16555 E 10 MILE RD",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480211192",
"telephone_number": "586-778-3838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16555 EAST 10 MILE",
"address_2": "GREAT EXPRESSION DENTAL CENTER RIVIERA PLAZA",
"city": "EAST POINTE",
"state": "MI",
"postal_code": "48021",
"telephone_number": "586-778-3838",
"fax_number": "586-778-3513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KTHAR",
"first_name": "AMAL",
"middle_name": "GANIM",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.