Individual provider Active NPI

Amine Bellil, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • West Des Moines, IA
National Provider Identifier
1639466733
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DDS-09277 Issued in IA
Practice address
6630 Mills Civic Pkwy
West Des Moines, IA 50266-8285
Phone
(515) 650-9582
NPI assigned
Jul 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056086 NY
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DDS-09277 IA Primary

Addresses

Primary practice location

6630 Mills Civic Pkwy
West Des Moines, IA 50266-8285

Mailing address

6500 Ep True Parkway
1306
West Des Moines, IA 50266
Phone (843) 343-4156

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-5993

Other practice location 2

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-5993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160819002005 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8022303767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056086NYMDDentist
DDS-09277IAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1310169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639466733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 EP TRUE PARKWAY",
            "address_2": "1306",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "50266",
            "telephone_number": "843-343-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 MILLS CIVIC PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502668285",
            "telephone_number": "515-650-9582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-5993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-5993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLIL",
        "first_name": "AMINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056086",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": "DDS-09277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.