Mohamed Othman

Primary specialty

DentistTaxonomy code 122300000X

License

30.024057 Issued in OH

Practice address

2124 Cornell Rd
Cleveland, OH 44106-3804

Phone

(734) 277-2897

NPI assigned

Jun 6, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1609214105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 LAKE AVE",
            "address_2": "APT 2007",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441071577",
            "telephone_number": "734-277-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CORNELL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441063804",
            "telephone_number": "734-277-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414004",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dragana Otasevic, CNP-APRN
• Bernard Kwadwo Oteng
• Brianne Otey
• Henry Biemann Othersen III, M.D.
• Dana Othman
• Yahya Azhar Othman, M.D.
• Diana Othon Martinez, MD
• Tyenna B Otis-Campbell
• Tyhesha Otis, CDCA
• Tia Otoo, LSW

• Dentist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.

Verify at the official NPI Registry.