Active NPI
Hassan Alshehabi
- General Practice Dentistry
- Green Bay, WI
National Provider Identifier
1063906188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1001880
- Practice address
- 430 Main St
Green Bay, WI 54301-5115 - Phone
- (920) 431-0345
- NPI assigned
- Jun 21, 2018
- Last updated
- Mar 4, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001880 | WI | Primary |
Addresses
Primary practice location
430 Main St
Green Bay, WI 54301-5115
Mailing address
430 Main St
Green Bay, WI 54301-5115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190916003491 | WI | Order and Referring Only - General Practice | 6002145018 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brew City Dental Care LLC | General Practice | Current | Accepting new patients |
| Delicate Smiles LLC | Current | Accepting new patients | |
| Dental Associates LTD of Wisconsin | General Practice | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Glendale, WI
- NPI 1225975147
-
- Dental Clinic/Center
- Milwaukee, WI
- NPI 1972204733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1063906188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 MAIN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543015115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 MAIN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543015115",
"telephone_number": "920-431-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALSHEHABI",
"first_name": "HASSAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-21",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1001880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
- Candena L Allenbrand, M.D.
- Allouez Family Dental Center SC
- Madeline C Almond, MD
- Almost Family Personal Care, LLC (Almost Family Personal Care)
- Alpha Family Limited Partnership (Bishop's Court)
- Hannah Lea Alsteen, FNP-C
- Altea Medical Wisconsin S.C.
- Nicole Aman, DNP, BC, APNP, PMHNP
- Richard Amankwah, MD
- Narayan H Amarnani, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.