Individual provider Active NPI

Ghiath Halwani

  • General Practice Dentistry
  • Anderson, IN
National Provider Identifier
1083776017
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12010049 Issued in IN
Practice address
2128 Mounds Rd
Anderson, IN 46016-5713
Phone
(765) 642-0400
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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 12010049 IN Primary

Addresses

Primary practice location

2128 Mounds Rd
Anderson, IN 46016-5713

Mailing address

2128 Mounds Rd
Anderson, IN 46016-5713
Phone (765) 642-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160506002029 IN Order and Referring Only - DentistPractitioner - Dentist 5597064808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12010049INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Dental at Saxony General Practice CurrentSince Jun 12, 2022 Accepting new patients

Locations

13578 E 131st St
Ste 103B
Fishers, IN 46037
Phone (317) 507-9906

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1083776017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 MOUNDS RD",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460165713",
            "telephone_number": "765-642-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 MOUNDS RD",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460165713",
            "telephone_number": "765-642-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALWANI",
        "first_name": "GHIATH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.