Active NPI
Sarah Shaikh Hussein
- General Practice Dentistry
- Coos Bay, OR
National Provider Identifier
1568032373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11573
- Practice address
- 1275 Fulton Avenue
Coos Bay, OR 97420 - Phone
- (541) 888-6433
- NPI assigned
- Jun 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11573 | OR | Primary |
Addresses
Primary practice location
1275 Fulton Avenue
Coos Bay, OR 97420
Mailing address
600 Technology Park
Lake Mary, FL 32746-7122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230928003209 | OR | Order and Referring Only - Dentist | 2466806146 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11573 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661904000000",
"number": "1568032373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 TECHNOLOGY PARK",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327467122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 FULTON AVENUE",
"city": "COOS BAY",
"state": "OR",
"postal_code": "97420",
"telephone_number": "541-888-6433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAIKH HUSSEIN",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-25",
"last_updated": "2022-08-31",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "11573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.