Individual provider Active NPI

Mohamad Alamin Hasan

  • Dentist
  • Lutz, FL
National Provider Identifier
1154906840
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN28053 Issued in FL
Practice address
23036 State Road 54 Ste 403
Lutz, FL 33549-6968
Phone
(813) 909-1317
NPI assigned
Mar 14, 2021
Last updated
Sep 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 DN28053 FL Primary

Addresses

Primary practice location

23036 State Road 54 Ste 403
Lutz, FL 33549-6968

Mailing address

23036 State Road 54 Ste 403
Lutz, FL 33549-6968
Phone (813) 909-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231012001684 FL Order and Referring Only - DentistPractitioner - Dentist 4385099266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Sep 21, 2025 Accepting new patients
Coast Florida P.a. Dentist PastSince Sep 21, 2025 Accepting new patients
Faculty Associates, Inc PastSince Mar 1, 2021 Accepting new patients

Locations

23036 State Road 54
Ste 403
Lutz, FL 33549
Phone (813) 909-1317

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1154906840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23036 STATE ROAD 54 STE 403",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496968",
            "telephone_number": "813-909-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23036 STATE ROAD 54 STE 403",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496968",
            "telephone_number": "813-909-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "MOHAMAD",
        "middle_name": "ALAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-14",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.