Provider Demographics
NPI:1003200890
Name:WALID THABET & PARTNERS LLC
Entity Type:Organization
Organization Name:WALID THABET & PARTNERS LLC
Other - Org Name:ANGEL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:
Authorized Official - Last Name:THABET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-630-2224
Mailing Address - Street 1:3370 W 117TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3605
Mailing Address - Country:US
Mailing Address - Phone:216-688-0900
Mailing Address - Fax:216-688-0937
Practice Address - Street 1:3370 W 117TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3605
Practice Address - Country:US
Practice Address - Phone:216-688-0900
Practice Address - Fax:216-688-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023527122300000X
OH018817122300000X
OH024296122300000X
OH022649122300000X
OH023405122300000X
OH023074122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2562043Medicaid
OH0071259Medicaid
OH2754818Medicaid
OH0105992Medicaid
OH3157542Medicaid
OH0058978Medicaid
OH0071286Medicaid