Ghassan R Antaki, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38024 Issued in CA

Practice address

961 Appalachian
Claremont, CA 91711-8307

Phone

(909) 625-2568

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

• Dr. Ghassan R Antaki Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 31, 2012.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1144302001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 APPALACHIAN",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917118307",
            "telephone_number": "909-625-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 APPALACHIAN",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917118307",
            "telephone_number": "909-625-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTAKI",
        "first_name": "GHASSAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GHASSAN",
            "last_name": "ANTAKI",
            "middle_name": "R",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Claremont, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.