Individual provider Active NPI

Ali Noori Daham, DDS

  • General Practice Dentistry
  • Lake Havasu City, AZ
National Provider Identifier
1740913938
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
39366 Issued in TX
Practice address
5665 Highway 95 N
Lake Havasu City, AZ 86404-9646
Phone
(323) 980-6661
NPI assigned
Jul 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 39366 TX Primary

Addresses

Primary practice location

5665 Highway 95 N
Lake Havasu City, AZ 86404-9646

Mailing address

11666 N 28TH Dr Unit 139
Phoenix, AZ 85029-5618
Phone (323) 980-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39366TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lamassu Dental PLLC General Practice Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1740913938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11666 N 28TH DR UNIT 139",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295618",
            "telephone_number": "323-980-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 HIGHWAY 95 N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864049646",
            "telephone_number": "323-980-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHAM",
        "first_name": "ALI",
        "middle_name": "NOORI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.