Abdulkader Ghadiali, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019.031244 Issued in IL

Practice address

16523 106TH CT Unit C2
Orland Park, IL 60467-4545

Phone

(708) 942-8154

Fax

(708) 551-0753

NPI assigned

Jun 28, 2017

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL

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

Locations

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.

• Premier Oral and Maxillofacial Surgery P.C.

  dba Premier Oral Surgery and Dental Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Orland Park, IL
  • NPI 1992534168
  NPD Authorized official
• Southwest Oral Surgeons,P.C.

  • Oral and Maxillofacial Pathology Dentistry
  • Oak Lawn, IL
  • NPI 1215123187
  NPD (past)

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736035200000",
    "number": "1215458468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16523 106TH CT UNIT C2",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-942-8154",
            "fax_number": "708-551-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16523 106TH CT UNIT C2",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-942-8154",
            "fax_number": "708-551-0753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHADIALI",
        "first_name": "ABDULKADER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "101707",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.031244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Anne Gesiorski, MA LPC
• Get It Straight Orthodontics Orland PK PC
• Natalie Gevaudan, PA-C
• Jessica Gewont
• Ahmed Ghaboun
• James Anthony Gianfrancisco, M.D.
• Tammi Gibbs, PTA
• Donna Gibson, COTA
• Mariana Gigea, MD
• Timothy R Gilbert

• Oral and Maxillofacial Surgery (Dentist) in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.