Active NPI
Kaoutar Mohamed Oumeddour, DDS
- Dentist
- Battle Creek, MI
National Provider Identifier
1265923809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901022634
- Practice address
- 5475 Beckley Rd Ste 100
Battle Creek, MI 49015 - Phone
- (269) 979-7710
- Fax
- (269) 979-7798
- NPI assigned
- May 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022634 | MI | Primary |
Addresses
Primary practice location
5475 Beckley Rd Ste 100
Battle Creek, MI 49015
Mailing address
350 N Clark St FL 6
Chicago, IL 60654-4712
Phone (269) 979-7710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022634 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Dreams PLLC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Battle Creek, MI
- NPI 1073912069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528588800000",
"number": "1265923809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 N CLARK ST FL 6",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544712",
"telephone_number": "269-979-7710",
"fax_number": "269-979-7798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5475 BECKLEY RD STE 100",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "49015",
"telephone_number": "269-979-7710",
"fax_number": "269-979-7798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUMEDDOUR",
"first_name": "KAOUTAR",
"middle_name": "MOHAMED",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-18",
"last_updated": "2018-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901022634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Battle Creek, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.