Ghazwan Al Kubaisi

Primary specialty

DentistTaxonomy code 122300000X

License

DN26294 Issued in FL

Practice address

1960 25TH Ave Ste 101
Vero Beach, FL 32960-3015

Phone

(561) 999-9650

NPI assigned

May 16, 2019

Last updated

Aug 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Sage Dental of Vero Beach PLLC

  • Dentist
  • Vero Beach, FL
  • NPI 1770159766
  NPD

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1154987915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 LYNN RD SW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553503151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 25TH AVE STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329603015",
            "telephone_number": "561-999-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL KUBAISI",
        "first_name": "GHAZWAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14196",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Airway & Sleep Solutions Inc (Airway & Sleep Solutions of Vero Beach)
• Adetola Olalekan Ajibade, M.D., M.S.
• Marlene Ann Marie Aking, M.D.
• Alexia N Akuchie
• Al Bucaj DMD PA
• Alan D Shoopak DMD Orthodontic Group IV LLC (Orthodontic Specialists of Florida)
• Stacie Albe, M.S., CCC-SLP
• Jeanne M. Albert, ARNP
• Jennifer Marie Albert, PTA
• Albertsons LLC (Savon Pharmacy)

• Dentist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.