DR. DERGHAM DERGHAM DDS NPI 1396022703

NPI Information

  • NPI: 1396022703
  • Provider Name: DR. DERGHAM DERGHAM, DDS
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4785 LEAVITT RD
    LORAIN, OH
    ZIP 44053
  • Phone: (440) 282-6677

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NPI Details

DR. Dergham Dergham, DDS is a pediatric dentistry dentist in Lorain, OH. The provider is 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. DR. Dergham Dergham, DDS NPI is 1396022703. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4785 LEAVITT RD
LORAIN, OH
ZIP 44053-136
Phone: (440) 282-6677

The NPI 1396022703 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/14/2011 and was last updated on 11/14/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry30-023579OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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