Active NPI
Omar Hassouna, DDS
- Dentist
- Lakewood, CA
National Provider Identifier
1942739693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103076
- Practice address
- 4443 Candlewood St
Lakewood, CA 90712-1736 - Phone
- (562) 634-5042
- NPI assigned
- Jun 7, 2017
- Last updated
- Oct 9, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 103076 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
4443 Candlewood St
Lakewood, CA 90712-1736
Mailing address
52 Sandfield Road
Toronto, ON M3B2B7
CA
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 |
|---|---|---|---|
| 103076 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bach Nguyen Dental Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Candlewood Smiles Dental Group
- General Practice Dentistry
- Lakewood, CA
- NPI 1952618183
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1942739693",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "52 SANDFIELD ROAD",
"city": "TORONTO",
"state": "ON",
"postal_code": "M3B2B7"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4443 CANDLEWOOD ST",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907121736",
"telephone_number": "562-634-5042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSOUNA",
"first_name": "OMAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-07",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103076",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.