Individual provider Active NPI

Haider Karkoosh

  • Dentist
  • Katy, TX
National Provider Identifier
1710764733
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL15964 Issued in MA
Practice address
2495 S Mason Rd
Katy, TX 77450-6068
Phone
(713) 584-5960
NPI assigned
Sep 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL15964 MA Primary

Addresses

Primary practice location

2495 S Mason Rd
Katy, TX 77450-6068

Mailing address

2495 S Mason Rd
Katy, TX 77450-6068
Phone (713) 584-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20240506003450 MA Practitioner - Dentist 9234579350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. CurrentSince Feb 26, 2024 Accepting new patients
Harbor Health Services, Inc. CurrentSince Feb 26, 2024 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1710764733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 S MASON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774506068",
            "telephone_number": "713-584-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 S MASON RD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774506068",
            "telephone_number": "713-584-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARKOOSH",
        "first_name": "HAIDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL15964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.