Active NPI
Mustapha Hotait, DDS
- Dentist
- Dolton, IL
National Provider Identifier
1518199850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019028015
- Practice address
- 1350 E Sibley Blvd
Suite 302
Dolton, IL 60419-2965 - Phone
- (708) 849-4644
- NPI assigned
- Aug 20, 2009
- Last updated
- Oct 6, 2021
- 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 | 019028015 | IL | Primary |
Addresses
Primary practice location
1350 E Sibley Blvd
Suite 302
Dolton, IL 60419-2965
Mailing address
8300 Valley Circle Blvd Ste B
West Hills, CA 91304-3023
Phone (183) 486-0688
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211207001146 | MI | Practitioner - Oral Surgery | 8820395254 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019028015 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Oaks Dental PLLC | Dentist | Current | Accepting new patients |
| Breathalife LLC | Dentist | Current | Accepting new patients |
Locations
8300 Valley Circle Blvd
Ste B
West Hills, CA 91304
Phone (818) 248-6068
3213 Rochester Rd
Royal Oak, MI 48073
Phone (248) 629-1830
Organizations & group practices 5
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.
-
- Dental Clinic/Center
- Chicago, IL
- NPI 1619212131
-
- Dentist
- Royal Oak, MI
- NPI 1588962351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1518199850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 VALLEY CIRCLE BLVD STE B",
"city": "WEST HILLS",
"state": "CA",
"postal_code": "913043023",
"telephone_number": "183-486-0688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E SIBLEY BLVD",
"address_2": "SUITE 302",
"city": "DOLTON",
"state": "IL",
"postal_code": "604192965",
"telephone_number": "708-849-4644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOTAIT",
"first_name": "MUSTAPHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-20",
"last_updated": "2021-10-06",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dolton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.