Jawad George Ghanayem, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019018562 Issued in IL

Practice address

1S132 Summit Ave
Ste 302
Oakbrook Terrace, IL 60181-3955

Phone

(630) 620-4370

NPI assigned

Jun 20, 2012

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 IL

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

State licenses

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1851654313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S132 SUMMIT AVE",
            "address_2": "STE 302",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813955",
            "telephone_number": "630-620-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S132 SUMMIT AVE",
            "address_2": "STE 302",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813955",
            "telephone_number": "630-620-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANAYEM",
        "first_name": "JAWAD",
        "middle_name": "GEORGE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019018562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.