Active NPI
Omar Bissar, DDS
- General Practice Dentistry
- Newport Coast, CA
National Provider Identifier
1801104419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 59692
- Practice address
- 5 Portica
Newport Coast, CA 92657-1223 - Phone
- (858) 361-6627
- NPI assigned
- Sep 16, 2010
- Last updated
- Mar 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 59692 | CA | Primary |
Addresses
Primary practice location
5 Portica
Newport Coast, CA 92657-1223
Mailing address
823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 906-4623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161103002571 | CA | Order and Referring Only - Other (Non-Physician) | 6406134998 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456963200000",
"number": "1801104419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 GATEWAY CENTER WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921024541",
"telephone_number": "619-906-4623",
"fax_number": "619-906-4564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 PORTICA",
"city": "NEWPORT COAST",
"state": "CA",
"postal_code": "926571223",
"telephone_number": "858-361-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISSAR",
"first_name": "OMAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-16",
"last_updated": "2016-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "59692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Coast, CA
- American Industrial Laboratories LLC (American Industrial Medserv)
- Apex Diagnostics Corporation
- Ariana Wellness Center
- Association of University Radiologists, PC
- Leigh Ann Bauman, RD
- Daniel Bui, D.M.D, M.D
- Tiet C Bui, MD
- Alanis Carisa Campbell, LCSW
- Jerry C. Cardenas, P.T.
- Edward George Deeb Jr., D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.