NPIMap

Organization Active NPI

S Ghannam DDS Inc

  • General Practice Dentistry
  • Antioch, CA
National Provider Identifier
1699987149
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44681 Issued in CA
Legal business name
S GHANNAM DDS INC
Practice address
2225 Buchanan Rd
Suite a
Antioch, CA 94509-4209
Phone
(925) 779-1112
NPI assigned
May 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Salam A Ghannam, DDS
Title
Ceo
Phone
(925) 779-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 44681 CA Primary

Addresses

Primary practice location

2225 Buchanan Rd
Suite a
Antioch, CA 94509-4209

Mailing address

2225 Buchanan Rd
Suite a
Antioch, CA 94509-4209
Phone (925) 779-1112

Other names 1

  • S GHANNAM DDS Doing business as

National Provider Directory

National Provider Directory

Locations

2225 Buchanan Rd
Ste A
Antioch, CA 94509
Phone (925) 727-3141

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1699987149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 BUCHANAN RD",
            "address_2": "SUITE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094209",
            "telephone_number": "925-779-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 BUCHANAN RD",
            "address_2": "SUITE A",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094209",
            "telephone_number": "925-779-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S GHANNAM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-05",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "GHANNAM",
        "authorized_official_first_name": "SALAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-779-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S GHANNAM DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.