Fady Assaad George Ibrahim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107914 Issued in CA

Practice address

9842 Adams Ave Ste 106
Huntington Beach, CA 92646-4827

Phone

(714) 968-4907

NPI assigned

Sep 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Magar and Sharifian Dental Corporation

  dba Beach Dental Group

  • General Practice Dentistry
  • Huntington Beach, CA
  • NPI 1962780007
  NPD (past)
• Sharifian and Huston Dental Corporation

  dba Beach Dental Group

  • General Practice Dentistry
  • Huntington Beach, CA
  • NPI 1447357686
  NPD (past)

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1902528748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9842 ADAMS AVE STE 106",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9842 ADAMS AVE STE 106",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926464827",
            "telephone_number": "714-968-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "FADY",
        "middle_name": "ASSAAD GEORGE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.hbdentalgroup.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9842 Adams Ave Ste 106",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926464827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julia Johanna Iacobellis, RD
• Claudia Ibarra
• Cynthia Ibarra
• Leslie Ibarra
• David Ibrahim
• Ghada Ibrahim
• Merna Bushra Ibrahim
• Takako Ibusuki, L.C.S.W.
• Sunita Ravinder Idnani, M.D.
• Yulia Olegovna Ievleva, LMFT

• General Practice Dentistry in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.

Verify at the official NPI Registry.