Active NPI
Christina Habib
- Dentist
- Phoenix, AZ
National Provider Identifier
1992188809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D009246
- Practice address
- 4017 N 75TH Ave
Phoenix, AZ 85033-3728 - Phone
- (623) 873-2500
- Fax
- (623) 873-2525
- NPI assigned
- Jul 9, 2015
- 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 | D009246 | AZ | Primary |
Addresses
Primary practice location
4017 N 75TH Ave
Phoenix, AZ 85033-3728
Mailing address
4017 N 75TH Ave
Phoenix, AZ 85033-3728
Phone (623) 873-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 250
Macy, NE 68039
PO Box
Suite 250
Macy, NE 68039-0250
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D009246 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primero Dental Services PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Glendale, AZ
- NPI 1558509869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436400000000",
"number": "1992188809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4017 N 75TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850333728",
"telephone_number": "623-873-2500",
"fax_number": "623-873-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4017 N 75TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850333728",
"telephone_number": "623-873-2500",
"fax_number": "623-873-2525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABIB",
"first_name": "CHRISTINA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-09",
"last_updated": "2015-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D009246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.