Individual provider Active NPI

Michael Imad Alharir, DDS

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1063893071
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS040930 Issued in PA
Practice address
2107B Cottman Ave
Philadelphia, PA 19149-1122
Phone
(215) 235-4060
NPI assigned
Jun 16, 2015
Last updated
May 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2022

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 DS040930 PA Primary

Addresses

Primary practice location

2107B Cottman Ave
Philadelphia, PA 19149-1122

Mailing address

1603 South St FL 1
Philadelphia, PA 19146-1541
Phone (215) 392-9178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170313002279 PA Order and Referring Only - DentistPractitioner - Dentist 9931484938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1063893071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 SOUTH ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461541",
            "telephone_number": "215-392-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107B COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491122",
            "telephone_number": "215-235-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALHARIR",
        "first_name": "MICHAEL",
        "middle_name": "IMAD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.