Nardeen Wahib

Primary specialty

DentistTaxonomy code 122300000X

License

DN29201 Issued in FL

Practice address

10955 Causeway Blvd
Brandon, FL 33511-1997

Phone

(813) 502-0346

NPI assigned

May 13, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael C Dickerson DMD Holdings PLLC

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1518507227
  NPD

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1073362174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10955 CAUSEWAY BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335111997",
            "telephone_number": "813-502-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10955 CAUSEWAY BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335111997",
            "telephone_number": "813-502-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHIB",
        "first_name": "NARDEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29201",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily G Wade, BCBA
• Betty Wadley, REGISTERED NURSE
• David J Wages, D.C.
• Amanda Wagner, M.ED., ED.S., LMFT
• Stephen Irwin Wagner, M.D.
• Katherine Waible, OTR/L
• Christopher Fitzgerald Waite, DMD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2387)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5826)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3463)

• Dentist in Brandon, FL
• Providers in Brandon, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.