DR. OMAR MARIO MASABNI (NPI# 1477089431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477089431 |
| Entity Type | Individual |
| Full Name | DR. OMAR MARIO MASABNI |
| Credential | B.D.S., M.S. |
| Practice Address |
2700 Martin Luther King Jr Blvd Detroit MI 48208-2576 |
| Practice Telephone | 3134946660 |
| Mailing Telephone | 3134946700 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
2901600593 | MI | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2700 MARTIN LUTHER KING JR BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48208-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144215005 | Salvatore Russell Cutino | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2005-09-16 |
| 1730780933 | Mariam Khan | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-11-04 |
| 1508466350 | Shriya Kulkarni | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-10-30 |
| 1487267373 | Ranjitha Rai Padhiar | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-08-28 |
| 1518575810 | Robert Samuel Herman | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-07-22 |
| 1598383267 | Tingxi Liu | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-07-09 |
| 1457976680 | Alexandria Horner | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-06-13 |
| 1184248692 | Asita Jenani Vinayagalingam | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-31 |
| 1659993384 | Monica Gandhi | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-15 |
| 1962023705 | Alexa Simmons | Student in an Organized Health Care Education/Training Program | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
| 1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
| 1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
| 1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
| 1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
| 1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
| 1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
| 1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| Find all providers in zip 48208 | ||||
| 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 |
|---|---|---|---|---|
| 1730780933 | Mariam Khan | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-11-04 |
| 1487267373 | Ranjitha Rai Padhiar | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2020-08-28 |
| 1003283557 | Karishma M Choksi | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-08-31 |
| 1023414240 | Hana Gadalla | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2014-11-16 |
| 1124458609 | Fatima A Tiwana | Dentist | 2700 Martin Luther King Jr Blvd, Udmsod Periodontology & Dental Hygiene, Detroit, MI 48208-2576 | 2013-11-19 |
| 1407286446 | Abdel-ghany Alsaidi | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2013-11-12 |
| 1154759249 | Kenneth Lee Hillenburg | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2013-10-29 |
| 1558626036 | Natasha Kapoor | Dentist | 500 River Place Dr, Apt 5103, Detroit, MI 48207-5030 | 2012-07-10 |
| 1356577498 | Darnell Kaigler D D S P C | Dentist | 2671 W Grand Blvd, Detroit, MI 48208-1203 | 2009-06-03 |
| 1487858585 | Luis Litonjua | Dentist | 2700 Martin Luther King Jr Blvd, Dept. of Periodontics, Detroit, MI 48208-2576 | 2007-06-13 |
| Find all providers in DETROIT | ||||
Please comment or provide details below to improve the information on DR. OMAR MARIO MASABNI.
| 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.