Hamzeh Charafeddine, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601113 Issued in MI

Practice address

1124 28TH St SW
Wyoming, MI 49509-2855

Phone

(616) 530-9900

NPI assigned

Jul 26, 2021

Last updated

Aug 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pro Dental Mi 1 PC

  dba Destiny Dental of Wyoming

  • General Practice Dentistry
  • Wyoming, MI
  • NPI 1326875600
  NPD

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1245903400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 ADAMS RIDGE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494239148",
            "telephone_number": "313-977-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 28TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092855",
            "telephone_number": "616-530-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482082576",
            "country_code": "US",
            "telephone_number": "313-494-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARAFEDDINE",
        "first_name": "HAMZEH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601113",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hamzehcharafeddine@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Professional Emaile",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7022 Garling Dr",
            "city": "Dearborn Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481272616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Cerrato
• Certified Emergency Medicine Specialists, PC
• Richard Stephen Cesarz
• Steven F Challa, DPM
• Tandy Champion, DO
• Emeline Charette
• Anita Irene Charochak, D.O.
• Tatyana S Chatman
• Cherinova Essentials LLC
• Cherry Street Services Inc (Godwin Heights Middle School)

• Dentist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.