Mina Ihab Habashi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.025497 Issued in OH

Practice address

36173 Euclid Ave Ste B
Willoughby, OH 44094-4410

Phone

(440) 290-4256

NPI assigned

Jun 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• John a Hudec DDS Inc

  • General Practice Dentistry
  • Cleveland, OH
  • NPI 1306878004
  NPD (past)
• John a Hudec DDS Specialty Services Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Cleveland, OH
  • NPI 1831121581

  General Practice

  NPD (past)

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1164916110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 CHENIN RUN",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111247",
            "telephone_number": "626-253-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36173 EUCLID AVE STE B",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944410",
            "telephone_number": "440-290-4256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3329 Broadview Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441093315",
            "country_code": "US",
            "telephone_number": "216-398-8900",
            "fax_number": "216-741-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABASHI",
        "first_name": "MINA",
        "middle_name": "IHAB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Gruenzel, MD
• Guardian Community Care LLC
• Nikki Guinn
• Kimberly Renee Gullatt
• Richard John Gustaferro, DDS
• Debra Habat
• Linda Hahn, LMT
• Dinko Hajdukovic, DPM
• Alva L Hall Jr.
• Michelle L Hall

• General Practice Dentistry in Willoughby, OH
• Providers in Willoughby, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.