Individual provider Active NPI

Hawazin Khedher, DMD

  • Dentist
  • Sterling Heights, MI
National Provider Identifier
1447512488
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020730 Issued in MI
Practice address
13525 Kingsville Dr
Sterling Heights, MI 48312-4133
Phone
(586) 864-0124
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020730 MI Primary

Addresses

Primary practice location

13525 Kingsville Dr
Sterling Heights, MI 48312-4133

Mailing address

13525 Kingsville Dr
Sterling Heights, MI 48312-4133
Phone (586) 864-0124

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
I20160412000417 MI Order and Referring Only - DentistPractitioner - Dentist 2769780550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1447512488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13525 KINGSVILLE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124133",
            "telephone_number": "586-864-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13525 KINGSVILLE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124133",
            "telephone_number": "586-864-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEDHER",
        "first_name": "HAWAZIN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.