Samar Koujan Basha, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019207 Issued in MI

Practice address

43455 Schoenherr Rd Ste 1
Sterling Heights, MI 48313-1973

Phone

(586) 323-1100

Fax

(586) 323-1141

NPI assigned

Jan 9, 2007

Sex

Female

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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.

• Basha Dental PLLC

  • General Practice Dentistry
  • Sterling Heights, MI
  • NPI 1043621758
  NPD (past) Authorized official

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1821147737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 MAPLERIDGE",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43455 SCHOENHERR RD STE 1",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131973",
            "telephone_number": "586-323-1100",
            "fax_number": "586-323-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUJAN BASHA",
        "first_name": "SAMAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilary Kostus
• Hardik Ramjibhai Kotadia, PT
• Kaitlin Koterba, CPNP
• Steven G Kotsonis, D.O.
• Payton Andronikidis Kott, MD
• Kathleen Kovach
• Amanda Kowalski
• Jenna Marie Kowalski
• Nicolai Joseph Kowalski
• Alyssa Kozak

• Dentist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.