Active NPI
Fadi Nabeel-Georges Matti
- Dentist
- Sterling Heights, MI
National Provider Identifier
1861147522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 107318
- Practice address
- 36177 Waltham Dr
Sterling Heights, MI 48310-4504 - Phone
- (248) 828-6031
- NPI assigned
- Feb 21, 2022
- Last updated
- Mar 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 107318 | CA | Primary |
Addresses
Primary practice location
36177 Waltham Dr
Sterling Heights, MI 48310-4504
Mailing address
36177 Waltham Dr
Sterling Heights, MI 48310-4504
Phone (248) 828-6031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107318 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1861147522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36177 WALTHAM DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483104504",
"telephone_number": "248-828-6031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36177 WALTHAM DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483104504",
"telephone_number": "248-828-6031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTI",
"first_name": "FADI",
"middle_name": "NABEEL-GEORGES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-02-21",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "107318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.