Individual provider Active NPI

Hisham F Nasr, D.D.S., M.SC.D.

  • Periodontics
  • Metairie, LA
National Provider Identifier
1104047976
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
4832 Issued in LA
Practice address
337 Metairie Road
Suite 301
Metairie, LA 70005
Phone
(504) 831-0800
Fax
(504) 831-0866
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 4832 LA Primary

Addresses

Primary practice location

337 Metairie Road
Suite 301
Metairie, LA 70005

Mailing address

337 Metairie Road
Suite 301
Metairie, LA 70005
Phone (504) 831-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160223002565 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0749585172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4832LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Perioclinic LLC Past Accepting new patients
The Perioclinic LLC Periodontics Past Accepting new patients

Organizations & group practices 2

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104047976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 METAIRIE ROAD",
            "address_2": "SUITE 301",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70005",
            "telephone_number": "504-831-0800",
            "fax_number": "504-831-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 METAIRIE ROAD",
            "address_2": "SUITE 301",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70005",
            "telephone_number": "504-831-0800",
            "fax_number": "504-831-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "HISHAM",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.SC.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "4832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.