Individual provider Active NPI

Laith Saadi Alsamerai

  • General Practice Dentistry
  • Ypsilanti, MI
National Provider Identifier
1396182259
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020936 Issued in MI
Practice address
2444 Packard Rd
Ypsilanti, MI 48197-1822
Phone
(734) 572-4428
NPI assigned
May 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020936 MI Primary

Addresses

Primary practice location

2444 Packard Rd
Ypsilanti, MI 48197-1822

Mailing address

1074 Jackson Xing
Jackson, MI 49202-2039
Phone (708) 445-2668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160323001987 MI Order and Referring Only - DentistPractitioner - Dentist 8022315712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020936MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Packard Family Dentistry, PC CurrentSince Jun 4, 2023 Accepting new patients

Locations

2444 Packard Rd
Ypsilanti, MI 48197
Phone (734) 572-4428

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1396182259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 JACKSON XING",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022039",
            "telephone_number": "708-445-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 PACKARD RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971822",
            "telephone_number": "734-572-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALSAMERAI",
        "first_name": "LAITH",
        "middle_name": "SAADI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.