Active NPI
Mohammad Abdurrahman Shuayb, DMD
- Dentist
- Spring Hill, FL
National Provider Identifier
1407877186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN15081
- Practice address
- 229 Mariner Blvd
Spring Hill, FL 34609 - Phone
- (352) 666-5133
- Fax
- (352) 684-5962
- NPI assigned
- Jul 21, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN15081 | FL | Primary |
Addresses
Primary practice location
229 Mariner Blvd
Spring Hill, FL 34609
Mailing address
229 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 666-5133
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36810 | Other | FL | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20180126002537 | FL | Order and Referring Only - Dentist | 9032479746 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN15081 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407877186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 MARINER BLVD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "34609",
"telephone_number": "352-666-5133",
"fax_number": "352-684-5962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 MARINER BLVD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "34609",
"telephone_number": "352-666-5133",
"fax_number": "352-684-5962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUAYB",
"first_name": "MOHAMMAD",
"middle_name": "ABDURRAHMAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN15081",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "36810",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spring Hill, FL
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.