Shadi Daher, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

18488 Issued in MA

Practice address

274 Newbury St
Boston, MA 02116-2403

Phone

(617) 262-0106

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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.

• 42 North Dental Care, LLC

  • Dental Clinic/Center
  • Boston, MA
  • NPI 1023387867
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063585354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 FOX HILL ST",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020901162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 NEWBURY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162403",
            "telephone_number": "617-262-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHER",
        "first_name": "SHADI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "18488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nujud Daham
• Haissam Dahan, DMD
• Shani Dahan, MD
• Jimmy Daher, MD
• Ralph Daher
• Shannon Alexis Daher
• Madhu Dahiya, M.D.
• Douglas Middleton Dahl, MD
• Mohammad A Dahlawi, MBBS
• Constance M Dahlin, NP

• Oral and Maxillofacial Surgery (Dentist) in Boston, MA
• Providers in Boston, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.