Hassan M Fayoumi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52604 Issued in CA

Practice address

8615 S Broadway
Kleinman & Wallace Prof Dental Corp
Los Angeles, CA 90003

Phone

(323) 752-3116

Fax

(323) 752-7203

NPI assigned

Nov 9, 2006

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: mfayoumi@direct.westerndental.com

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.

• Kleinman & Wallace Professional Dental Corp

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1386727667
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831269489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 N JUANITA AVE",
            "address_2": "#3",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-699-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 S BROADWAY",
            "address_2": "KLEINMAN & WALLACE PROF DENTAL CORP",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90003",
            "telephone_number": "323-752-3116",
            "fax_number": "323-752-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYOUMI",
        "first_name": "HASSAN",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faye Lee M D a Medical Corporation
• Adrianne Faye, MFT
• Heather B Faye, DC
• Leonard John Faye, D.C.
• Marisa Fenarjian Faynsod, LCSW
• Karolina Faysman, N.P.
• Fayton Inc
• Zafeer Fazelbhoy
• Bahar Fazeli, M.D.
• Shima Fazelimanesh, RD

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.