Mohamad Hassan Abdul Azim

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2952000741 Issued in MI

Practice address

2900 N Saginaw St
Flint, MI 48505-4452

Phone

(909) 636-1584

NPI assigned

May 21, 2018

Last updated

Oct 7, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1649761065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRANCISCAN PL",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917664867",
            "telephone_number": "909-636-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485054452",
            "telephone_number": "909-636-1584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDUL AZIM",
        "first_name": "MOHAMAD HASSAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2952000741",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nazem Abdelfattah, MD
• Erika M Abdelhak, CHW
• Abdella Eyecare, PC
• John Philip Abdella, O.D.
• Hussein Abdellatif, M.D.
• Nour Abduljalil, DDS
• Abdullah Raffee MD. PC
• Ahmed Abdullah, MD
• Dana Abel, M.A. CCC-SLP
• Above the Water House, Inc

• General Practice Dentistry in Flint, MI
• Providers in Flint, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.