Individual provider Active NPI

Mustafa Suhail Hamawi

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1124515242
Registry record updated Apr 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
RS.003929 Issued in OH
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 312-5977
NPI assigned
Apr 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2018

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 RS.003929 OH Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

54 Morross Cir
Dearborn, MI 48126-2396
Phone (313) 421-0183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180725000474 OH Order and Referring Only - DentistPractitioner - Dentist 9830446699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RS.003929OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1124515242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MORROSS CIR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262396",
            "telephone_number": "313-421-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-312-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMAWI",
        "first_name": "MUSTAFA",
        "middle_name": "SUHAIL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-14",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "RS.003929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.