Individual provider Active NPI

Diaa Ghabbour

  • General Practice Dentistry
  • Wesley Chapel, FL
National Provider Identifier
1962504209
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15155 Issued in FL
Practice address
5348 County Road 581
Wesley Chapel, FL 33543
Phone
(813) 973-1837
NPI assigned
Sep 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 DN15155 FL Primary

Addresses

Primary practice location

5348 County Road 581
Wesley Chapel, FL 33543

Mailing address

2502 N Rocky Point Dr
Suite 1000-Credentialing
Tampa, FL 33607-1421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20151104001467 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436469392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Health Management PLLC Past Accepting new patients
Adam Diasti DDS & Associates P.C. Past Accepting new patients
Coast Florida P.a. Past Accepting new patients
Coast Florida P.a. PastSince Jun 22, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962504209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 N ROCKY POINT DR",
            "address_2": "SUITE 1000-CREDENTIALING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5348 COUNTY ROAD 581",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33543",
            "telephone_number": "813-973-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHABBOUR",
        "first_name": "DIAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.