Omar E Elbanhawy, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901021020 Issued in MI

Practice address

561 Woods LN
Grosse Pointe, MI 48236-1160

Phone

(410) 982-8440

NPI assigned

Oct 14, 2010

Last updated

Jun 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MI

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bloomfield Hills Dental Group PLLC

  • Periodontics
  • Bloomfield Hills, MI
  • NPI 1902473374
  NPD Authorized official
• Great Lakes Dental Group PLLC

  dba Dental Implant Center of Royal Oak

  • Periodontics
  • Royal Oak, MI
  • NPI 1053199141
  NPD
• Periodontic and Implantology Specialists PLLC

  • Periodontics
  • Farmington Hills, MI
  • NPI 1346828068
  NPD (past)
• Periodontic PLLC

  • Periodontics
  • Farmington Hills, MI
  • NPI 1629256094
  NPD (past)

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1780994533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 WOODS LN",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482361160",
            "telephone_number": "410-982-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 WOODS LN",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482361160",
            "telephone_number": "410-982-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBANHAWY",
        "first_name": "OMAR",
        "middle_name": "E",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401412910",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901021020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard A Eichbauer, CRNA
• Mahdi Houssein El Ankouni
• Lara El Masri, MD
• Natalie El-Alam, PSY.D
• Michelle El-Hosni, MD
• Allison Clare Everett Elston, D.D.S.
• Natalia Engel, DPT
• Ashley Esper, DPT
• James Atkinson Everett, DDS
• Peter Farago III, M.D.

• Periodontics in Grosse Pointe, MI
• Providers in Grosse Pointe, MI by specialty
• Periodontics in Michigan

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