Individual provider Active NPI

Ghayth Adhami, D.D.S

  • General Practice Dentistry
  • Arlington, TX
National Provider Identifier
1629384433
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25857 Issued in TX
Practice address
1030 W Arkansas LN
Ste 210
Arlington, TX 76013-6377
Phone
(817) 543-2222
NPI assigned
Aug 31, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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 25857 TX Primary

Addresses

Primary practice location

1030 W Arkansas LN
Ste 210
Arlington, TX 76013-6377

Mailing address

2103 Harvard Cir
Corona, CA 92881-7469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160428001166 TX Order and Referring Only - DentistPractitioner - Dentist 0042524423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25857TXMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Home Town Dental of Arlington PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1629384433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 HARVARD CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W ARKANSAS LN",
            "address_2": "STE 210",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136377",
            "telephone_number": "817-543-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADHAMI",
        "first_name": "GHAYTH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.