Bassel Samir Haddad, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

057110 Issued in NY

Practice address

30 Waterside PLZ
Apt 16H
New York, NY 10010-2622

Phone

(319) 521-5577

NPI assigned

Jan 7, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1740602986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WATERSIDE PLZ",
            "address_2": "APT 16H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WATERSIDE PLZ",
            "address_2": "APT 16H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102622",
            "telephone_number": "319-521-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "BASSEL",
        "middle_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057110",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marzieh Hadavi, LMSW, LCPSYA
• Shawn Hadavi
• Cynthia Hadaya, PA-C
• Ceri E Hadda, M.D.
• Andre Moshe Haddad, MD
• David Haddad, O.D.
• Edmond Haddad, O.D.
• Ghassan George Haddad, MD
• Heidi Haddad, LCSW
• Jessica Michelle Haddad, MD

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.