Jay Ibrahim Haddad, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

13498 Issued in MD

Practice address

6550 Mercantile Dr E Ste 101
Frederick, MD 21703-7656

Phone

(301) 694-0870

Fax

(301) 694-7034

NPI assigned

Dec 13, 2005

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

Other names 1

• Dr. Jihad Ibrahim Haddad Former name

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 May 13, 2016 through May 13, 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.

• Associated Oral & Maxillofacial Surgeons, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Martinsburg, WV
  • NPI 1346310505
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1790760700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 240",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-617-3404",
            "fax_number": "301-617-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 MERCANTILE DR E STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037656",
            "telephone_number": "301-694-0870",
            "fax_number": "301-694-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "JAY",
        "middle_name": "IBRAHIM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "13498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIHAD",
            "last_name": "HADDAD",
            "middle_name": "IBRAHIM",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Justin Gutterman, LMSW
• Kathryn Guynn, OT
• David Evans Gwinn, MD
• Richard Maurice Haber, M.D.
• Dana M Hackey, LCSW-C
• Anita Raina Raj Hadden, M.A.
• Erik Hadden, M.A.
• Sabah Mehdi Hadi, MD
• Daniel L. Haffey, PSY.D.
• Rachel Elaine Haffey, LPC

• Oral and Maxillofacial Surgery (Dentist) in Frederick, MD
• Providers in Frederick, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.