Mohanad Al-Sabbagh, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8148 Issued in KY

Practice address

800 Rose St
Lexington, KY 40536-0297

Phone

(859) 323-6193

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Credentials

Master of Science

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1699875591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "address_2": "D104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360297",
            "telephone_number": "859-323-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-SABBAGH",
        "first_name": "MOHANAD",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8148",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KY",
            "license": "8148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9177550",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60003340",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar Muhsin Ali Al Janabi, MD
• Fadi Al Nimri, MD
• Haider Nadhim Al-Awadi, MD
• Mais Al-Kawaz, MD
• Leesah Al-Qawasmi, MD
• Aysha Al-Sahlawi, MD
• Moayad Al-Sona', MD
• Anna Kathleen Alagusundaramoorthy, APRN
• Fawad Alam
• Mohammed Ahmed Thabet Alameldeen

• Periodontics in Lexington, KY
• Providers in Lexington, KY by specialty
• Periodontics in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.