Obai Takieddin

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN31926 Issued in FL

Practice address

1060 S US Highway 441
Lady Lake, FL 32159-5237

Phone

(352) 268-1387

NPI assigned

Oct 9, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1972384873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 HILLSIDE PARK ST APT 6211",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347156167",
            "telephone_number": "678-322-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595237",
            "telephone_number": "352-268-1387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 South 40th Street",
            "address_2": "Office of Clinical Affairs-S6A Evans",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191046030",
            "country_code": "US",
            "telephone_number": "215-573-2588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAKIEDDIN",
        "first_name": "OBAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-09",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN31926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.