Mohammad Waddah Al-Sabbagh, DMD
Individual provider Active NPI Dentist · Willoughby Hills, OH
NPI 1679205504 · NPPES record last updated Aug 12, 2022
Key facts
- NPI
- 1679205504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30.020388 (OH)
- Practice address
- 27291 Chardon Rd
Willoughby Hills, OH 44092-2900 - Phone
- (440) 278-4042
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.020388 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.020388 | OH | Yes |
Addresses
Primary practice location
27291 Chardon Rd
Willoughby Hills, OH 44092-2900
Mailing address
32367 Hamilton CT Apt B208
Solon, OH 44139-4872
Phone (267) 665-4477
Other providers in Willoughby Hills, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.