Individual provider Active NPI

Edward George Khamis, D.D.S.

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1912197484
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013857 Issued in MI
Practice address
31701 Plymouth Rd
Livonia, MI 48150-1936
Phone
(734) 427-2241
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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 013857 MI Primary

Addresses

Primary practice location

31701 Plymouth Rd
Livonia, MI 48150-1936

Mailing address

31701 Plymouth Rd
Livonia, MI 48150-1936
Phone (734) 427-2241

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
I20170215001552 MI Order and Referring Only - DentistPractitioner - Dentist 8820371982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013857MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1912197484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31701 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501936",
            "telephone_number": "734-427-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31701 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501936",
            "telephone_number": "734-427-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "EDWARD",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "013857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.