NPIMap

Organization Active NPI

Mustapha Hotait DDS PC

  • Dental Clinic/Center
  • Dolton, IL
National Provider Identifier
1306267265
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MUSTAPHA HOTAIT DDS PC
Practice address
1350 E Sibley Blvd
Suite 302
Dolton, IL 60419-2965
Phone
(313) 999-8889
NPI assigned
Dec 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Mustapha Hotait
Title
President
Phone
(313) 999-8889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X IL Primary

Addresses

Primary practice location

1350 E Sibley Blvd
Suite 302
Dolton, IL 60419-2965

Mailing address

1350 E Sibley Blvd
Suite 302
Dolton, IL 60419-2965
Phone (313) 999-8889

Other identifiers 1

IdentifierTypeStateIssuer
9222481MedicaidIL

Other names 1

  • DOLTON DENTAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dolton Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1306267265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E SIBLEY BLVD",
            "address_2": "SUITE 302",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192965",
            "telephone_number": "313-999-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E SIBLEY BLVD",
            "address_2": "SUITE 302",
            "city": "DOLTON",
            "state": "IL",
            "postal_code": "604192965",
            "telephone_number": "313-999-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTAPHA HOTAIT DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "HOTAIT",
        "authorized_official_first_name": "MUSTAPHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-999-8889"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9222481",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOLTON DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dolton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.