Individual provider Active NPI

Yazan F Karadsheh, DDS

  • Dentist
  • Madison, OH
National Provider Identifier
1881972255
Registry record updated Mar 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024024 Issued in OH
Practice address
6248 North Ridge Road
Madison, OH 44057-4405
Phone
(440) 454-5436
NPI assigned
Aug 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.024024 OH Primary

Addresses

Primary practice location

6248 North Ridge Road
Madison, OH 44057-4405

Mailing address

6248 North Ridge Road
Madison, OH 44057-3719
Phone (440) 454-5436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150724012311 CA Order and Referring Only - DentistPractitioner - Dentist 3779896329
I20160309003039 OH Order and Referring Only - DentistPractitioner - Dentist 3779896329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024024OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Above and Beyond Dental , LLC Current Accepting new patients
Yazan F Karadsheh DDS LLC PastSince Mar 26, 2023 Accepting new patients

Organizations & group practices 2

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679702400000",
    "number": "1881972255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6248 NORTH RIDGE ROAD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573719",
            "telephone_number": "440-454-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6248 NORTH RIDGE ROAD",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440574405",
            "telephone_number": "440-454-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARADSHEH",
        "first_name": "YAZAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2023-03-25",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

Verify at the official NPI Registry.