Rula Sabah Odeh Amarin, DDS, MS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

019033219 Issued in IL

Practice address

1811 Lindenwood Ave
Edwardsville, IL 62025-2580

Phone

(618) 659-0456

NPI assigned

Jul 3, 2021

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Edwardsville Family Dentist

  • Dental Clinic/Center
  • Edwardsville, IL
  • NPI 1063899417
  NPD

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

{
    "created_epoch": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1083285704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 LINDENWOOD AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252580",
            "telephone_number": "618-659-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 LINDENWOOD AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252580",
            "telephone_number": "618-659-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARIN",
        "first_name": "RULA",
        "middle_name": "SABAH ODEH",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019033219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Prosthodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.