Islam Eldib, LLD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DL13240 Issued in MA

Practice address

338 Montague City Rd
Turners Falls, MA 01376-1830

Phone

(413) 774-2615

NPI assigned

Jun 13, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: ieldib322362@direct.ochin.org

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497312000000",
    "number": "1609306703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 MONTAGUE CITY RD",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013761830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 MONTAGUE CITY RD",
            "city": "TURNERS FALLS",
            "state": "MA",
            "postal_code": "013761830",
            "telephone_number": "413-774-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDIB",
        "first_name": "ISLAM",
        "credential": "LLD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DL13240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Health Center of Franklin County Incorporated
• Connecticut River Internists, LLP
• Daniel Cohen, DMD, PC
• Kathleen Licata Dodge
• Garry L. Earles, M.S.W., L.I.C.S.W.
• Farren Care Center, Inc.
• Colleen Yvonne Ferris
• Paul Stradley Flandreau, M.D., M.ED.
• Margaux Isabella Smith Frank, SLP
• Franklin County Technical School

• All providers in Turners Falls, MA
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.