Noor Almudallal

Primary specialty

DentistTaxonomy code 122300000X

License

30-024265 Issued in OH

Practice address

250 S Chestnut St
Suite 30
Ravenna, OH 44266-3031

Phone

(330) 297-7009

NPI assigned

Jul 3, 2014

Last updated

Jul 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luxesmiles, LLC

  • General Practice Dentistry
  • Cleveland, OH
  • NPI 1477327120
  NPD Authorized official

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1942616545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST",
            "address_2": "SUITE 30",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CHESTNUT ST",
            "address_2": "SUITE 30",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663031",
            "telephone_number": "330-297-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMUDALLAL",
        "first_name": "NOOR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Edward Alexander, PH.D.
• Robert Lee Alexander
• Pamela Louise Alkins
• All Things Creative Therapy LLC
• Rabeena Alli, PCC
• Alpine House of Ravenna Inc (Alpine Healthcare)
• Jonathan Altany
• Celeste Alters
• Hannah Renee Amos, LPN
• Audra A Amreihn, ST

• Dentist in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.