Active NPI
Hazem Dabbour
- Dentist
- Manhattan, IL
National Provider Identifier
1902315286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019031418
- Practice address
- 175 S State St
Manhattan, IL 60442-9019 - Phone
- (815) 478-7788
- NPI assigned
- Sep 29, 2017
- Last updated
- Apr 29, 2024
- 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 | 019031418 | IL | Primary |
Addresses
Primary practice location
175 S State St
Manhattan, IL 60442-9019
Mailing address
2816 Easton St
Downers Grove, IL 60515-3882
Phone (267) 432-5709
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 |
|---|---|---|---|
| 019031418 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manhattan Dental LLC | Current | Accepting new patients | |
| Illinois Dental Providrs (Schaumburg), P.C. | Dentist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Manhattan, IL
- NPI 1760059687
-
dba DentalWorks of Schaumburg
- General Practice Dentistry
- Schaumburg, IL
- NPI 1407828031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1902315286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2816 EASTON ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605153882",
"telephone_number": "267-432-5709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 S STATE ST",
"city": "MANHATTAN",
"state": "IL",
"postal_code": "604429019",
"telephone_number": "815-478-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DABBOUR",
"first_name": "HAZEM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-29",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019031418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.