Active NPI
Nadia Hatoum
- Dentist
- West Allis, WI
National Provider Identifier
1962084764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1002572
- Practice address
- 555 S 108TH St
West Allis, WI 53214-1100 - Phone
- (312) 307-6779
- NPI assigned
- Apr 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1002572 | WI | Primary |
Addresses
Primary practice location
555 S 108TH St
West Allis, WI 53214-1100
Mailing address
1801 W Wisconsin Ave
Milwaukee, WI 53233-2186
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 |
|---|---|---|---|
| 1002572 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1962084764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532332186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 S 108TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532141100",
"telephone_number": "312-307-6779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATOUM",
"first_name": "NADIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-22",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1002572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.