Mohamed Mahmoud Hussien Ha Shehab

Primary specialty

DentistTaxonomy code 122300000X

License

DDS101785 Issued in CA

Practice address

2740 S Elm Ave
Fresno, CA 93706-5435

Phone

(559) 457-5200

NPI assigned

Aug 15, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1215453840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 N SAYBROOK DR APT 129",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200640",
            "telephone_number": "415-530-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 S ELM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065435",
            "telephone_number": "559-457-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHAB",
        "first_name": "MOHAMED",
        "middle_name": "MAHMOUD HUSSIEN HA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS101785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Fresno, CA
• Providers in Fresno, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.