Active NPI
Houssam Elchekha, DDS
- General Practice Dentistry
- Racine, WI
National Provider Identifier
1396096574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7001-15
- Practice address
- 4915 Washington Ave
Racine, WI 53406-4221 - Phone
- (414) 306-6420
- Fax
- (877) 335-3684
- NPI assigned
- Sep 27, 2012
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7001-15 | WI | Primary |
Addresses
Primary practice location
4915 Washington Ave
Racine, WI 53406-4221
Mailing address
2572 S 76TH St
West Allis, WI 53219-2476
Phone (414) 306-6420
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 |
|---|---|---|---|
| 7001-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1396096574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2572 S 76TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532192476",
"telephone_number": "414-306-6420",
"fax_number": "877-335-3684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4915 WASHINGTON AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534064221",
"telephone_number": "414-306-6420",
"fax_number": "877-335-3684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELCHEKHA",
"first_name": "HOUSSAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-27",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "7001-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.