Individual provider Active NPI

Haider A Alzubaidi, DDS MS

  • Endodontics
  • Lakeland, FL
National Provider Identifier
1528246501
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN16935 Issued in FL
Practice address
3003 S Florida Ave
Ste 101
Lakeland, FL 33803-4050
Phone
(863) 687-8990
Fax
(863) 682-0871
NPI assigned
Feb 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN16935 FL Primary

Addresses

Primary practice location

3003 S Florida Ave
Ste 101
Lakeland, FL 33803-4050

Mailing address

3003 S Florida Ave
Ste 101
Lakeland, FL 33803-4050
Phone (863) 687-8990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150819008405 FL Order and Referring Only - DentistPractitioner - Dentist 0446565485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1528246501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 S FLORIDA AVE",
            "address_2": "STE 101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034050",
            "telephone_number": "863-687-8990",
            "fax_number": "863-682-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 S FLORIDA AVE",
            "address_2": "STE 101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034050",
            "telephone_number": "863-687-8990",
            "fax_number": "863-682-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALZUBAIDI",
        "first_name": "HAIDER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-01",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN16935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.