Individual provider Active NPI

Noah Koraym, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Alamitos, CA
National Provider Identifier
1497331185
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
018.002185 Issued in IL
Practice address
11162 Los Alamitos Blvd
Los Alamitos, CA 90720-3621
Phone
(937) 321-6285
NPI assigned
Mar 22, 2021
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 018.002185 IL Primary

Addresses

Primary practice location

11162 Los Alamitos Blvd
Los Alamitos, CA 90720-3621

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (937) 321-6285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220120001231 IL Order and Referring Only - DentistPractitioner - Dentist 4486046679

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018.002185ILMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Noah Koraym, DDS, Inc. CurrentSince Jun 15, 2025 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

11162 Los Alamitos Blvd
Los Alamitos, CA 90720
Phone (562) 598-8604

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Interoperability endpoints

  • Direct secure messaging: nkoraym139866@direct.luhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1497331185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "937-321-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11162 LOS ALAMITOS BLVD",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203621",
            "telephone_number": "937-321-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORAYM",
        "first_name": "NOAH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "018.002185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.