Individual provider Active NPI

Mohamed Kazbour, DDS

  • Dentist
  • Napoleon, OH
National Provider Identifier
1124810221
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.028024 Issued in OH
Practice address
875 Westmoreland Ave
Napoleon, OH 43545-1260
Phone
(877) 478-0988
NPI assigned
May 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.028024 OH Primary

Addresses

Primary practice location

875 Westmoreland Ave
Napoleon, OH 43545-1260

Mailing address

1141 Golfview Dr
Dearborn, MI 48128-1439
Phone (313) 610-5066

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
I20250912002550 OH Order and Referring Only - DentistPractitioner - Dentist 7517460710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.028024OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1124810221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 GOLFVIEW DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281439",
            "telephone_number": "313-610-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WESTMORELAND AVE",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435451260",
            "telephone_number": "877-478-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZBOUR",
        "first_name": "MOHAMED",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.028024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napoleon, OH

Sources for this page

Verify at the official NPI Registry.