Individual provider Active NPI

Alhusain Ghazala, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1962060491
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.032100 Issued in IL
Practice address
2249 S California Ave Apt 2R
Chicago, IL 60608-3538
Phone
(586) 823-2988
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032100 IL Primary

Addresses

Primary practice location

2249 S California Ave Apt 2R
Chicago, IL 60608-3538

Mailing address

2249 S California Ave Apt 2R
Chicago, IL 60608-3538
Phone (586) 823-2988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190702001543 IL Order and Referring Only - DentistPractitioner - Dentist 0143554733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.032100ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1962060491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 S CALIFORNIA AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083538",
            "telephone_number": "586-823-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 S CALIFORNIA AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083538",
            "telephone_number": "586-823-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAZALA",
        "first_name": "ALHUSAIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.