Bassam A Issa, B.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AC5385578-R608 Issued in NC

Practice address

1000 Blythe Blvd
Charlotte, NC 28203-5812

Phone

(704) 355-4197

Fax

(704) 355-5301

NPI assigned

May 5, 2010

Sex

Male

Sole proprietor

Yes

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

Enrolled in IL

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": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1659699379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-4197",
            "fax_number": "704-355-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-4197",
            "fax_number": "704-355-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSA",
        "first_name": "BASSAM",
        "middle_name": "A",
        "credential": "B.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "AC5385578-R608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Miller Isles
• Hicham Ismail, M.D.
• Isoken Express Lab LLC
• Isoken Home Care Solutions
• Rachel Marie Isom, RD
• It Takes a Village Youth and Family Services
• Its Gooden Good Life Coaching and Counseling
• Its Up to You LLC
• Alexander Philip Iuliano, PA-C
• Margaret Iuliano, PT

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.