Al Khateeb D.D.S Dental Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

41699 Issued in CA

Legal business name

AL KHATEEB D.D.S DENTAL CORPORATION

Practice address

267 E 17TH St
Costa Mesa, CA 92627-3831

Phone

(714) 000-0000

NPI assigned

Oct 17, 2016

Last updated

Apr 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hisham Alkhatheeb, D.D.S

Title

Owner

Phone

(714) 000-0000

Specialties & licenses 1

Addresses

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.

• Maha Hetata, D.D.S.

  • General Practice Dentistry
  • Costa Mesa, CA
  • NPI 1154678647
  NPD (past)

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1558812420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E 17TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E 17TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273831",
            "telephone_number": "714-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AL KHATEEB D.D.S DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "ALKHATHEEB",
        "authorized_official_first_name": "HISHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-000-0000",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "41699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.