Individual provider Active NPI

Yazan Haddadeen, DDS

  • Dentist
  • Cleveland, OH
National Provider Identifier
1205099520
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.023405 Issued in OH
Practice address
5716 Broadway Ave
Cleveland, OH 44127-1715
Phone
(216) 415-5504
NPI assigned
Jul 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60199807 WA
Dentist 122300000X 30.023405 OH Primary

Addresses

Primary practice location

5716 Broadway Ave
Cleveland, OH 44127-1715

Mailing address

5716 Broadway Ave
Cleveland, OH 44127-1715
Phone (216) 415-5504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.023405OHMDDentist
DE60199807WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dental Art Thabet DDS LLC Current Accepting new patients
Elite Dental Art Ghazal DDS LLC Current Accepting new patients

Locations

5716 Broadway Ave
Cleveland, OH 44127
Phone (216) 415-5504

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1205099520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271715",
            "telephone_number": "216-415-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271715",
            "telephone_number": "216-415-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDADEEN",
        "first_name": "YAZAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60199807",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.