Individual provider Active NPI

Hussein H Fakih

  • Dentist
  • Tigard, OR
National Provider Identifier
1386520492
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12209 Issued in OR
Practice address
10705 SW 71St Ave
Tigard, OR 97223-8702
Phone
(503) 860-1314
NPI assigned
Aug 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12209 OR Primary

Addresses

Primary practice location

10705 SW 71St Ave
Tigard, OR 97223-8702

Mailing address

10705 SW 71St Ave
Tigard, OR 97223-8702
Phone (503) 860-1314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20251111001692 OR Order and Referring Only - DentistPractitioner - Dentist 7911498647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12209ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1386520492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10705 SW 71ST AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238702",
            "telephone_number": "503-860-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 SW 71ST AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238702",
            "telephone_number": "503-860-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKIH",
        "first_name": "HUSSEIN",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D12209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.