Individual provider Active NPI

Suhair Hasan, DMD

  • General Practice Dentistry
  • Hammonton, NJ
National Provider Identifier
1518494764
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02694500 Issued in NJ
Practice address
860 S White Horse Pike
Hammonton, NJ 08037
Phone
(609) 567-0200
Fax
(609) 561-9383
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02694500 NJ Primary

Addresses

Primary practice location

860 S White Horse Pike
Hammonton, NJ 08037

Mailing address

1 N White Horse Pike
Hammonton, NJ 08037-1875
Phone (609) 567-0200

Other practice location 1

7710 W North Ave
Elmwood Park, IL 60707-4123
Phone (708) 453-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20181009000034 NJ Order and Referring Only - DentistPractitioner - Dentist 9234481961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02694500NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kudos Dental Care Inc General Practice Past Accepting new patients
Confidental Group LLC Past Accepting new patients

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1518494764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "080371875",
            "telephone_number": "609-567-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "08037",
            "telephone_number": "609-567-0200",
            "fax_number": "609-561-9383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Elmwood Park",
            "state": "IL",
            "postal_code": "607074123",
            "country_code": "US",
            "telephone_number": "708-453-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASAN",
        "first_name": "SUHAIR",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02694500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.