Active NPI
Basman Kraidi, DDS
- Dentist
- Erie, PA
National Provider Identifier
1518453059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600407
- Practice address
- 7165 Peach St
Erie, PA 16509-4764 - Phone
- (814) 864-1500
- NPI assigned
- Jul 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS041818 | PA | |
| Dentist | 122300000X | 2901600407 | MI | Primary |
Addresses
Primary practice location
7165 Peach St
Erie, PA 16509-4764
Mailing address
2258 Lakeview Dr
Erie, PA 16506-6401
Phone (619) 277-2911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901600407 | MI | MD | Dentist |
| DS041818 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1518453059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2258 LAKEVIEW DR",
"city": "ERIE",
"state": "PA",
"postal_code": "165066401",
"telephone_number": "619-277-2911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7165 PEACH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165094764",
"telephone_number": "814-864-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAIDI",
"first_name": "BASMAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-09",
"last_updated": "2022-03-16",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS041818",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.