Active NPI
Ali Ahmad Sobh, DDS
- Dentist
- Dearborn, MI
National Provider Identifier
1376625558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017157
- Practice address
- 14639 Ford Rd
Dearborn, MI 48126-3173 - Phone
- (313) 582-1960
- Fax
- (313) 582-2414
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 2901017157 | MI | Primary |
Addresses
Primary practice location
14639 Ford Rd
Dearborn, MI 48126-3173
Mailing address
14639 Ford Rd
Dearborn, MI 48126-3173
Phone (313) 582-1960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150609001436 | WI | Order and Referring Only - Oral Surgery | 6305167859 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017157 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ali a Sobh DDS PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376625558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14639 FORD RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263173",
"telephone_number": "313-582-1960",
"fax_number": "313-582-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14639 FORD RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263173",
"telephone_number": "313-582-1960",
"fax_number": "313-582-2414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOBH",
"first_name": "ALI",
"middle_name": "AHMAD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.