Mustafa Obaidi, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019030653 Issued in IL

Practice address

3420 W Elm St
McHenry, IL 60050-4433

Phone

(815) 344-0453

NPI assigned

Jun 7, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oms Dental LLC

  • Dental Clinic/Center
  • McHenry, IL
  • NPI 1841874526
  NPD Authorized official
• Confidental Group LLC

  • Dental Clinic/Center
  • Elmwood Park, IL
  • NPI 1376044305
  NPD (past) Authorized official
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1811065576
  NPD
• Dougla R. Colthurst D.D.S.,Inc

  • General Practice Dentistry
  • McHenry, IL
  • NPI 1568475218
  NPD (past)
• Kudos Dental Care Inc

  • General Practice Dentistry
  • Elmwood Park, IL
  • NPI 1225485113
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1043669419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 W ELM ST",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504433",
            "telephone_number": "815-344-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 W ELM ST",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504433",
            "telephone_number": "815-344-0453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W PATERSON ST",
            "address_purpose": "LOCATION",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7710 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Elmwood Park",
            "state": "IL",
            "postal_code": "607074123",
            "country_code": "US",
            "telephone_number": "708-453-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBAIDI",
        "first_name": "MUSTAFA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030653",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer O'Connor
• Christopher Patrick O'Hara, MD
• Tara Jo O'Neill
• Diana Richelle O'Rourke
• Olabode O Obafemi
• Folashade Obasa
• Ma Jenzen Romano Oconnor
• Toluwani Oconnor
• Ikponmwosa Jude Ogieuhi, M.D
• Christiana Omowunmi Olarinde

• Dentist in McHenry, IL
• Providers in McHenry, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.