Active NPI
Abdelazeem Hazem Desoky, DDS
- Periodontics
- Beachwood, OH
National Provider Identifier
1093157018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- RES.3147
- Practice address
- 27060 Cedar Rd
806
Beachwood, OH 44122-8103 - Phone
- (216) 672-8064
- NPI assigned
- Jul 18, 2013
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | RES.3147 | OH | Primary |
Addresses
Primary practice location
27060 Cedar Rd
806
Beachwood, OH 44122-8103
Mailing address
27060 Cedar Rd
806
Beachwood, OH 44122-8103
Phone (216) 672-8064
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 |
|---|---|---|---|
| RES.3147 | OH | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1093157018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27060 CEDAR RD",
"address_2": "806",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441228103",
"telephone_number": "216-672-8064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27060 CEDAR RD",
"address_2": "806",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441228103",
"telephone_number": "216-672-8064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOKY",
"first_name": "ABDELAZEEM",
"middle_name": "HAZEM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-18",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OH",
"license": "RES.3147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.