John Nabil Nassif Estemalik, BSC, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30.024590 Issued in OH

Practice address

7131 Spring MDWS W Ste C
Holland, OH 43528-7938

Phone

(419) 865-7433

NPI assigned

Mar 15, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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.

• Professional Dental Alliance Specialty, LLC

  • Endodontics
  • Holland, OH
  • NPI 1346796869
  NPD (past)

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1760723738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7131 SPRING MDWS W STE C",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287938",
            "telephone_number": "419-865-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTEMALIK",
        "first_name": "JOHN",
        "middle_name": "NABIL NASSIF",
        "credential": "BSC, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-15",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30.024590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul James Eby, MD, MPH
• Calvin Holland Elliott
• Darcel Elliott
• Encouraging Homes LLC
• Jamie English
• Taundra Lavae Ezell, CDAC
• Sharla Nichols Fasko, PHD
• Laurie Elaine Ferguson, RN
• Caitlin Faye Fidell, PT, DPT
• Jenell Suzanne Fitzgerald, PCPNP

• Periodontics in Holland, OH
• Providers in Holland, OH by specialty
• Periodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.