Ibrahim Shehadeh

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

48371984 Issued in TX

Practice address

5228 Dillon Cir
Haltom City, TX 76137-5508

Phone

(317) 499-8298

NPI assigned

Jun 9, 2023

Last updated

Dec 10, 2023By 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 1

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": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702166400000",
    "number": "1669156816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5228 DILLON CIR",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761375508",
            "telephone_number": "317-499-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5228 DILLON CIR",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761375508",
            "telephone_number": "317-499-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHADEH",
        "first_name": "IBRAHIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "TX",
            "license": "48371984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SD Haltom City PLLC
• Khankham Kaitlyn Senesoury, NP
• Veronica Settles, LVN
• Hamid Jay Shafi, DDS
• Cherie R Shaw, LCDC-M.S, QMHP
• Joanna Shores, MS CCC SLP
• Andrea Silvestri, DDS
• SK Dental PLLC
• Christina G Smith, B.S., M.A, LPC
• Tierra Smith, B.A.

• Private Vehicle in Haltom City, TX
• Providers in Haltom City, TX by specialty
• Private Vehicle in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2023; 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.