Active NPI
Reda El-Zein Ismail, DDS
- Dentist
- Dearborn, MI
National Provider Identifier
1871757849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901019780
- Practice address
- 9925 Dix Ste 101
Dearborn, MI 48120-1593 - Phone
- (313) 841-5522
- NPI assigned
- Jul 17, 2008
- Last updated
- May 18, 2009
- Sex
- Male
- Sole proprietor
- No
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 | 2901019780 | MI | Primary |
Addresses
Primary practice location
9925 Dix Ste 101
Dearborn, MI 48120-1593
Mailing address
7401 Kendal St
Dearborn, MI 48126-1307
Phone (313) 802-2034
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160722001130 | MI | Order and Referring Only - Dentist | 7416240825 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901019780 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1871757849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7401 KENDAL ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481261307",
"telephone_number": "313-802-2034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9925 DIX STE 101",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201593",
"telephone_number": "313-841-5522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISMAIL",
"first_name": "REDA",
"middle_name": "EL-ZEIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-17",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901019780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; 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.