Individual provider Active NPI

Haider Aljewari, DMD

  • Periodontics
  • Champaign, IL
National Provider Identifier
1245686724
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
019.030669 Issued in IL
Practice address
3002 Crossing CT
Champaign, IL 61822-6135
Phone
(956) 414-5979
NPI assigned
May 13, 2016
Last updated
May 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 019.030669 IL Primary
Periodontics 1223P0300X DN24635 FL

Addresses

Primary practice location

3002 Crossing CT
Champaign, IL 61822-6135

Mailing address

3002 Crossing CT
Champaign, IL 61822-6135
Phone (956) 414-5979

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630002850 FL Order and Referring Only - DentistPractitioner - Dentist 9032578570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN24635FLMDPeriodontist
019.030669ILMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Haider W Aljewari DMD Ms PLLC Periodontics Current Accepting new patients

Locations

3002 Crossing Ct
Champaign, IL 61822
Phone (217) 398-4594

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1245686724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 CROSSING CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226135",
            "telephone_number": "956-414-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 CROSSING CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226135",
            "telephone_number": "956-414-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALJEWARI",
        "first_name": "HAIDER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019.030669",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN24635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.