DR. MOAWIA KASSAB (NPI# 1164436150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164436150 |
| Entity Type | Individual |
| Full Name | DR. MOAWIA KASSAB |
| Credential | DDS, MS |
| Practice Address |
1801 W Wisconsin Ave Marquette University, Dental School, Surgical Sciences Milwaukee WI 53233-2186 |
| Practice Telephone | 4142880771 |
| Practice Fax Number | 4142888392 |
| Mailing Telephone | 4142880771 |
| Mailing Fax Number | 4142888392 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
11-875 | WI | Dental Providers |
| Street Address |
1801 W WISCONSIN AVE MARQUETTE UNIVERSITY, DENTAL SCHOOL, SURGICAL SCIENCES |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53233-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982693099 | Brian David Hodgson | Dentist | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2005-10-20 |
| 1114524493 | Jamie L Perugini | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-10-08 |
| 1063036143 | Manasa Rao | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-06-03 |
| 1265054332 | Mari Liestman | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-05-12 |
| 1790307965 | Vy Nguyen | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-05-11 |
| 1073135349 | Sara Jean Link | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-05-10 |
| 1588285696 | Hannah Lea Bonikowske | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-04-29 |
| 1932728425 | James Dentino | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-04-14 |
| 1396374070 | Alexander Vaun Padalino | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-04-05 |
| 1487283404 | Charles Allen Hauge | Student in an Organized Health Care Education/Training Program | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2020-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104454750 | Henok Desta Hardilo | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center 945 N 12th Street, Milwaukee, WI 53233 | 2020-03-30 |
| 1821633314 | Ann E Millard | Occupational Therapist | 560 N. 16th Street, Room 214a, Milwaukee, WI 53233 | 2019-11-08 |
| 1306480918 | Teng Kai Ong | Dentist | 1801 West Wisconsin Ave., Milwaukee, WI 53233 | 2019-11-06 |
| 1356800478 | Nebiyu Abera Tilahun | Student in an Organized Health Care Education/Training Program | Aurora Sinai Medical Center, 945 N. 12th Street, Milwaukee, WI 53233 | 2019-03-18 |
| 1548748387 | Emily Claire Goetz | Physical Therapist | 945 N. 12th St. Suite 1100, Milwaukee, WI 53233 | 2018-08-03 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1184170706 | Lauren Troll | Physical Therapist | 925 N 12th Street, Milwaukee, WI 53233 | 2016-09-01 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1649676032 | Matina Angelopoulou | Dentist | 1801 West Winsconsin Ave, Milwaukee, WI 53233 | 2014-11-12 |
| 1780007831 | John Ladisa | Technician, Other | 1637 W. Wisconsin Ave, Room 311, Milwaukee, WI 53233 | 2014-01-27 |
| Find all providers in zip 53233 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891903043 | Denise Y Shih | Dentist | 2853 N Marietta Ave, Milwaukee, WI 53211-3420 | 2007-05-20 |
| 1720016900 | Royal Ellinger | Dentist | Milwaukee Va Medical Center / Dental Clinic, 5000 National Ave, Milwaukee, WI 53295-0001 | 2006-06-28 |
| 1144282542 | Drs Hoge & Jarzembinski, Ltd | Dentist | 6944 North Port Washington Rd, Milwaukee, WI 53217 | 2006-04-03 |
| 1952785271 | Vrisiis Kofina | Dentist | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2015-07-16 |
| 1902284185 | Arndt Guentsch | Dentist | 1801 W Wisconsin Ave, Milwaukee, WI 53233-2186 | 2015-05-08 |
| 1699078683 | Stanley I Sehler | Dentist | 2300 N Mayfair Rd Ste 705, Milwaukee, WI 53226-1533 | 2010-12-13 |
| 1326248881 | Renita C Burrell | Dentist | 2457 N Mayfair Rd, Ste 102, Milwaukee, WI 53226-1405 | 2007-07-23 |
| 1912093386 | Nancy Ann Barnett | Dentist | 316 E Silver Spring Dr, Suite 238, Milwaukee, WI 53217-5274 | 2006-10-05 |
| 1548356702 | Gay M Derderian | Dentist | 1801 West Wisconsin Ave, Milwaukee, WI 53233 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235683830 | Phillip Crum | Dentist | 2581 Development Dr Ste 204, Bellevue, WI 54311-4248 | 2016-08-11 |
| 1285937557 | Craig William Byers | Dentist | 2457 North Mayfair Road, Suite 102, Wauwatosa, WI 53226-1405 | 2010-12-08 |
| 1558662387 | Jason William Cooke | Dentist | 2557b E Calumet St, Appleton, WI 54915-4748 | 2010-11-10 |
| 1780998997 | Thomas C. Kelley Dds Msd LLC | Dentist | 17280 W North Ave Ste 203, Brookfield, WI 53045-4366 | 2010-07-29 |
| 1376789933 | Shoreline Periodontics Limited | Dentist | 2808 Kohler Memorial Dr, Suite 2, Sheboygan, WI 53081-3177 | 2008-12-31 |
| 1003052895 | James P. Herman | Dentist | 5624 S Bonnie Ln, Hales Corners, WI 53130-1674 | 2008-12-28 |
| 1760684930 | Jeffrey Joseph Burke | Dentist | 2323 S 109th St Ste 275, West Allis, WI 53227-1912 | 2007-06-01 |
| 1992915276 | Scott George Metskas | Dentist | 3364 Iris Ln, Stevens Point, WI 54481-5618 | 2007-05-23 |
| 1134339500 | Fox River Periodontics Sc | Dentist | 2557b East Calumet St, Appleton, WI 54915 | 2007-05-23 |
| 1629280987 | Nancy Ellen Shumate | Dentist | 2600 N Mayfair Rd Ste 340, Wauwatosa, WI 53226-1372 | 2007-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.