Individual provider Active NPI

Omran Hammoud, D.D.S.

  • General Practice Dentistry
  • West Bloomfield, MI
National Provider Identifier
1871855841
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020646 Issued in MI
Practice address
5777 W Maple Rd Ste 160
West Bloomfield, MI 48322-4448
Phone
(248) 851-2980
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020646 MI Primary

Addresses

Primary practice location

5777 W Maple Rd Ste 160
West Bloomfield, MI 48322-4448

Mailing address

5777 W Maple Rd Ste 160
West Bloomfield, MI 48322-4448
Phone (248) 851-2980

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170519000820 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4688986862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Convenient DB PC Inc. General Practice Past Accepting new patients
Brightside Dental General Practice Past Accepting new patients
Midwestdental of Dearborn Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1871855841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD STE 160",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224448",
            "telephone_number": "248-851-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 W MAPLE RD STE 160",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224448",
            "telephone_number": "248-851-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOUD",
        "first_name": "OMRAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.