Organization Active NPI

Mariam M. Habib, D.D.S., L.L.C.

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1528414588
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN20984 Issued in FL
Legal business name
MARIAM M. HABIB, D.D.S., L.L.C.
Practice address
801 Paul St
Orlando, FL 32808-7544
Phone
(407) 290-0367
NPI assigned
May 9, 2016
Last updated
May 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Authorized official

Name
Mariam Habib, D.D.S.NPI 1851706485
Title
Owner
Phone
(407) 290-0367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20984 FL Primary

Addresses

Primary practice location

801 Paul St
Orlando, FL 32808-7544

Mailing address

801 Paul St
Orlando, FL 32808-7544
Phone (407) 290-0367

Other identifiers 1

IdentifierTypeStateIssuer
015110700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221202000014 FL Part B Supplier - Clinic/Group Practice 1557739125 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

801 Paul St
Orlando, FL 32808
Phone (407) 290-0367

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1528414588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PAUL ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087544",
            "telephone_number": "407-290-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PAUL ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087544",
            "telephone_number": "407-290-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAM M. HABIB, D.D.S., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "HABIB",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-290-0367",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015110700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.