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DR. DERGHAM DERGHAM DDS
NPI 1396022703
Dentist - Pediatric Dentistry in Lorain, OH

Active since November 14, 2011PECOS Enrolled
4785 LEAVITT RD, LORAIN, OH 44053(440) 282-6677 Get Directions Write a Review

NPPES record last updated: November 14, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Dergham Dergham Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DERGHAM DERGHAM DDS (NPI 1396022703) is an individual pediatric dentistry provider in Lorain, Ohio, licensed in Ohio (30-023579) and active in the NPI registry since November 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396022703
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameDR. DERGHAM DERGHAMCredential: DDS
Location Address4785 LEAVITT RDLorain, OH 44053-2136
Mailing Address4785 Leavitt RoadLorain, OH 44053 · (440) 282-6677
Phone(440) 282-6677
Sole ProprietorNo
Enumeration DateNovember 14, 2011
✔ NPI 1396022703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in OH · 30-023579
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
4785 LEAVITT RD, Lorain, OH 44053
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dergham Dergham Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44053 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FERNANDO ALBERTO FALCON ANDARA
Dentist
4785 LEAVITT RD
LORAIN, OH 44053
Lorain County (440) 282-6677
DR. RICHARD KUN
Dentist (General Practice)
4785 LEAVITT RD
LORAIN, OH 44053
Lorain County (440) 282-6677
DR. JOSE PH JABBOURE DDS
Dentist (General Practice)
4785 LEAVITT RD
LORAIN, OH 44053
Lorain County (440) 282-6677
DENTAL PROFESSIONALS CLEVELAND-NOUNEH, INC.
Clinic/Center (Dental)
4785 LEAVITT RD
LORAIN, OH 44053
Lorain County (440) 282-6677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dergham Dergham's NPI number?

The NPI number for Dergham Dergham is 1396022703. It was assigned to this individual provider in the NPPES registry on November 14, 2011.

Where is Dergham Dergham located?

Dergham Dergham practices at 4785 Leavitt Rd, Lorain, OH 44053. The listed phone number is (440) 282-6677.

What is Dergham Dergham's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Dergham Dergham enrolled in Medicare?

Yes. Dergham Dergham is registered in the Medicare PECOS enrollment system.

What insurance does Dergham Dergham accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 13 other insurers list Dergham Dergham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dergham Dergham was last updated on November 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.