Individual provider Active NPI

Nidal H Hammoud, DDS

  • Dentist
  • Woodhaven, MI
National Provider Identifier
1679949127
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021663 Issued in MI
Practice address
21080 Allen Rd
Woodhaven, MI 48183-1602
Phone
(734) 676-1656
Fax
(734) 362-8662
NPI assigned
Aug 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021663 MI Primary

Addresses

Primary practice location

21080 Allen Rd
Woodhaven, MI 48183-1602

Mailing address

21080 Allen Rd
Woodhaven, MI 48183-1602
Phone (734) 676-1656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901021663MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1679949127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-676-1656",
            "fax_number": "734-362-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-676-1656",
            "fax_number": "734-362-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOUD",
        "first_name": "NIDAL",
        "middle_name": "H",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.