Active NPI
Yasser Khaled
- Dentist
- Charlotte, NC
National Provider Identifier
1427448307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 151029
- Practice address
- 1000 Blythe Blvd
CMC Dental Clinic
Charlotte, NC 28203-5812 - Phone
- (704) 355-2165
- NPI assigned
- Jan 29, 2015
- 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 | 151029 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
CMC Dental Clinic
Charlotte, NC 28203-5812
Mailing address
1000 Blyth Boulvard
CMC Dental Clinic
Charlotte, NC 28203-5812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 2, 2017 through Oct 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151029 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1427448307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTH BOULVARD",
"address_2": "CMC DENTAL CLINIC",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"address_2": "CMC DENTAL CLINIC",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "704-355-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALED",
"first_name": "YASSER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-29",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "151029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.