Active NPI
Haitham Nabood
- Dentist
- Chesterfield, MI
National Provider Identifier
1174139893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901602813
- Practice address
- 27891 23 Mile Rd
Chesterfield, MI 48051-2328 - Phone
- (586) 808-8865
- NPI assigned
- Sep 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901602813 | MI | Primary |
Addresses
Primary practice location
27891 23 Mile Rd
Chesterfield, MI 48051-2328
Mailing address
51628 Times Square Dr
Shelby Township, MI 48315-2459
Phone (586) 808-8865
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210122002373 | FL | Order and Referring Only - Dentist | 5395159966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602813 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761696000000",
"number": "1174139893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51628 TIMES SQUARE DR",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483152459",
"telephone_number": "586-808-8865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27891 23 MILE RD",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480512328",
"telephone_number": "586-808-8865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NABOOD",
"first_name": "HAITHAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-17",
"last_updated": "2025-10-29",
"certification_date": "2025-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901602813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.