Active NPI
Iya Ghassib, DDS,MS
- Periodontics
- Richmond, VA
National Provider Identifier
1891408126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401418640
- Practice address
- 520 N 12TH St
Richmond, VA 23298-5064 - Phone
- (734) 604-7960
- NPI assigned
- Jan 2, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401418640 | VA | Primary |
Addresses
Primary practice location
520 N 12TH St
Richmond, VA 23298-5064
Mailing address
520 N 12TH St
Richmond, VA 23298-5064
Phone (734) 604-7960
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401418640 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1891408126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 N 12TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232985064",
"telephone_number": "734-604-7960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 N 12TH ST",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232985064",
"telephone_number": "734-604-7960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHASSIB",
"first_name": "IYA",
"credential": "DDS,MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-02",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401418640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.