Mohammed Khalil Shaker Al-Baghdadi

Primary specialty

DentistTaxonomy code 122300000X

License

D011751 Issued in AZ

Practice address

230 S 12TH Ave
Phoenix, AZ 85007-3101

Phone

(602) 362-0744

NPI assigned

Apr 21, 2022

Last updated

Sep 28, 2023By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Western Dental of Arizona, Inc.

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1093851016
  NPD (past)

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1801530373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W TIERRA BUENA LN UNIT 1103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850234519",
            "telephone_number": "520-308-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S 12TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850073101",
            "telephone_number": "602-362-0744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13651 N 35th Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850291267",
            "country_code": "US",
            "telephone_number": "602-504-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-BAGHDADI",
        "first_name": "MOHAMMED",
        "middle_name": "KHALIL SHAKER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011751",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed Al Qazzaz
• Salem Al Rabadi, MD
• Mania Al Rezk
• Yousif Al Rubaye, MD
• Jumanah Al Sumairi
• Yazan Al-Hasan, MD
• Hatim S Al-Jaroushi, M.D
• Layth Al-Jashaami, M.D
• Rasha Adil Abduljabbar Al-Kaabi, DMD
• Ahmad Al-Khashman

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.