Ida Med LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDA MED LLC

Doing business as

Excel Dental

Practice address

800 W Layton Ave
Milwaukee, WI 53221-2427

Phone

(414) 334-1080

NPI assigned

Dec 5, 2024

Organization subpart

Yes

Parent organization

EXCEL DENTALAs reported in NPPES

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

Authorized official

Name

Mahmoud AlsharkawiNPI 1285233635

Title

Owner

Phone

(414) 334-1080

Specialties & licenses 1

Addresses

Other names 1

• Excel Dental Doing business as

Part of

Ida Med LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahmoud Alsharkawi, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • St Francis, WI
  • NPI 1285233635
  NPD Authorized official

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1447066410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W LAYTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212427",
            "telephone_number": "414-334-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W LAYTON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212427",
            "telephone_number": "414-334-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA MED LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCEL DENTAL",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "ALSHARKAWI",
        "authorized_official_first_name": "MAHMOUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-334-1080"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.