Mohamed Ibrahim, BDS, MS, PHD, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

18061-875 Issued in WI

Practice address

1250 W Wisconsin Ave
Milwaukee, WI 53233-2225

Phone

(414) 288-3455

NPI assigned

Nov 16, 2015

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

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.

Opted out of Medicare

Previously, effective Sep 1, 2016 through Sep 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1659745529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18320 TAYWOOD CIR APT 202",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455681",
            "telephone_number": "319-512-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332225",
            "telephone_number": "414-288-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "BDS, MS, PHD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-16",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "18061-875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usonwanne Uchenna Ibekwe, M.D.
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• Roy Grant Ibrado
• Ibraheem Imaging Service LLC
• Mary Maher Ibrahim, MA
• Mohamed Yousif Mohamed Ibrahim, M.D.
• Mona Ibrahim
• Icare Prenatal.Agency Inc
• Icare4Women
• Icf Consultants, Inc.

• Endodontics in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.