Individual provider Active NPI

Omar Nijem, DDS

  • General Practice Dentistry
  • Miami, FL
National Provider Identifier
1245735166
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN26555 Issued in FL
Practice address
1717 N Bayshore Dr Ste 235
Miami, FL 33132-1180
Phone
(844) 393-2894
NPI assigned
Mar 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 060479 NY
General Practice Dentistry 1223G0001X DN26555 FL Primary

Addresses

Primary practice location

1717 N Bayshore Dr Ste 235
Miami, FL 33132-1180

Mailing address

3725 S Ocean Dr Apt 1610
Hollywood, FL 33019-2989
Phone (845) 803-1751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190313000700 PA Order and Referring Only - DentistPractitioner - Dentist 2860732724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060479NYMDDentist
DN26555FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Heart LLC General Practice PastSince Dec 1, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8835/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1245735166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 S OCEAN DR APT 1610",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192989",
            "telephone_number": "845-803-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N BAYSHORE DR STE 235",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331321180",
            "telephone_number": "844-393-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIJEM",
        "first_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "060479",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN26555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.