Maytham Falah Qaisi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.037359 Issued in IL

Practice address

4100 10TH Street Dr
Moline, IL 61265-6885

Phone

(309) 491-8197

NPI assigned

Jun 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shachindrabahadur DDS PC

  • General Practice Dentistry
  • Cedar Rapids, IA
  • NPI 1508169467
  NPD (past)

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1306407226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 10TH STREET DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 10TH STREET DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656885",
            "telephone_number": "309-491-8197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3280 Redhawk St",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522418537",
            "country_code": "US",
            "telephone_number": "319-729-8082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QAISI",
        "first_name": "MAYTHAM",
        "middle_name": "FALAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.037359",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J Pugliano, LCSW
• Pulse Counseling & Wellness Center PLLC
• Sanjeev Puri, M.D.
• Vijay Rock Puri, DC
• Srinivasan S Purighalla, MD
• QC Cpap Direct, LLC
• QC OBGYN Associates SC
• QC Wellness Center, LLC
• Quad Cities Autism Center Inc.
• Quad Cities Eye Care, LLC

• General Practice Dentistry in Moline, IL
• Providers in Moline, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.