Mariam Alexes Hamidi, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00009207 Issued in WA

Practice address

322 SE 192ND Ave Ste 100
Vancouver, WA 98683-9679

Phone

(360) 262-4504

NPI assigned

Jan 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 9, 2016 through Feb 9, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Frontier Oral Surgery and Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Cheyenne, WY
  • NPI 1114291887
  NPD (past) Authorized official

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1710967252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2193 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986071707",
            "telephone_number": "307-509-9735",
            "fax_number": "800-952-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SE 192ND AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839679",
            "telephone_number": "360-262-4504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "443 NW Burnside Rd",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303714",
            "country_code": "US",
            "telephone_number": "503-492-8487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMIDI",
        "first_name": "MARIAM",
        "middle_name": "ALEXES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OR",
            "license": "D10787",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "D9281",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00009207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn David Hamby
• Patricia Cecilia Hamelin
• Molly Hames
• Olivia Hames
• Damla M Hamide, LMHCA
• Patricia Marie Hamil
• Cheryl A. Hamilton-Jefferson, MA, LMHC
• Sasha M Hamilton-Wooten
• Andrea Hamilton
• Dawn Hamilton

• Oral and Maxillofacial Surgery (Dentist) in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.