Active NPI
Wiam Ismail, DDS
- Dentist
- Aurora, CO
National Provider Identifier
1083419568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 00206064
- Practice address
- 12090 E Alameda Ave
Aurora, CO 80012-1216 - Phone
- (303) 360-8365
- NPI assigned
- Feb 18, 2025
- Last updated
- Feb 18, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 00206064 | CO | Primary |
Addresses
Primary practice location
12090 E Alameda Ave
Aurora, CO 80012-1216
Mailing address
2200 N Ursula St Apt 230
Aurora, CO 80045-7604
Phone (832) 712-6017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00206064 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1083419568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 N URSULA ST APT 230",
"city": "AURORA",
"state": "CO",
"postal_code": "800457604",
"telephone_number": "832-712-6017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12090 E ALAMEDA AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800121216",
"telephone_number": "303-360-8365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISMAIL",
"first_name": "WIAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-18",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "00206064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.