Individual provider Active NPI

Rami Khalil, DDS

  • General Practice Dentistry
  • Jackson, MI
National Provider Identifier
1548787997
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901022252 Issued in MI
Practice address
1074 Jackson Xing
Jackson, MI 49202-2039
Phone
(517) 841-0000
NPI assigned
Aug 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 2901022252 MI Primary

Addresses

Primary practice location

1074 Jackson Xing
Jackson, MI 49202-2039

Mailing address

1074 Jackson Xing
Jackson, MI 49202-2039

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

LicenseStateTypeSpecialty
2901022252MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Dental Mi 1 PC General Practice CurrentSince Sep 23, 2024 Accepting new patients
D2 Dental of Michigan General Practice PastSince Sep 29, 2019 Accepting new patients

Locations

1074 Jackson Xing
Jackson, MI 49202
Phone (517) 841-0000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1548787997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 JACKSON XING",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 JACKSON XING",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022039",
            "telephone_number": "517-841-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "RAMI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-26",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.