Nada Samir Ilia, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN20413 Issued in FL

Practice address

8390 N Palafox St
Promed Dental Clinic
Pensacola, FL 32534

Phone

(850) 471-6983

NPI assigned

Jul 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Nada Yacoub Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1043565781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5631 SANDSTONE DR",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "216-496-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 N PALAFOX ST",
            "address_2": "PROMED DENTAL CLINIC",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32534",
            "telephone_number": "850-471-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIA",
        "first_name": "NADA",
        "middle_name": "SAMIR",
        "name_prefix": "Mrs.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADA",
            "last_name": "YACOUB",
            "prefix": "MS.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mudasser Ibrahim, MD
• Sherif Ibrahim, M.D.
• Roger D Iburg
• Ideal Optical Inc
• Mackenzie Keir Ikenberry, MS CGC
• Imaging Center of Pensacola Inc
• John Toby Imm, B.C.O.
• Ana Imtiaz, MBBS
• In Home Recovery Care (Irc)
• In the Comfort of Home, Inc.

• General Practice Dentistry in Pensacola, FL
• Providers in Pensacola, 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 21, 2015; 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.