DR. GHANEM M. GHANNAM D.D.S. - NPI 1770612780

Q: What is Ghanem Ghannam's NPI number?

The NPI number for Ghanem Ghannam is 1770612780. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Q: What is Ghanem Ghannam's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Ghanem Ghannam was last updated on August 8, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Ghanem M. Ghannam D.d.s. NPPES

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

DR. GHANEM M. GHANNAM D.D.S. (NPI 1770612780) is an individual oral and maxillofacial surgery provider in Detroit, Michigan, licensed in Michigan (014082) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770612780

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. GHANEM M. GHANNAMCredential: D.D.S.

Location Address5705 W VERNOR HWYDetroit, MI 48209-2157

Mailing Address5705 W Vernor HwyDetroit, MI 48209-2157 · (313) 842-3770

Phone(313) 842-3770

Sole ProprietorNo

Enumeration DateMarch 5, 2007

Last NPPES UpdateAugust 8, 2024

NPPES CertifiedAugust 8, 2024

✔ NPI 1770612780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in MI · 014082

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 014082 (MI)

5705 W VERNOR HWY, Detroit, MI 48209

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Other Identifiers 1

Medicaid1692476MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, Delta Dental of Michigan.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. Ghanem M. Ghannam D.d.s. 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 48209 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

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 10

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

DR. ELHAM JAVIDAN-NEJAD DDS

Dentist