NPIMap

Organization Active NPI

Abc Dentistry Old Spanish Trail, PLLC

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1013230788
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18929 Issued in TX
Legal business name
ABC DENTISTRY OLD SPANISH TRAIL, PLLC
Practice address
5751 Blythewood St
Ste 100
Houston, TX 77021-5402
Phone
(281) 593-3300
Fax
(281) 593-1616
NPI assigned
Mar 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Armin Jabbary, DMDNPI 1689251019
Title
President
Phone
(713) 944-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 18929 TX Primary

Addresses

Primary practice location

5751 Blythewood St
Ste 100
Houston, TX 77021-5402

Mailing address

1500 Southmore Ave
Pasadena, TX 77502-1307
Phone (713) 944-6800

Other identifiers 1

IdentifierTypeStateIssuer
210698101MedicaidTX

Other names 1

  • ABC DENTAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160603001224 TX Part B Supplier - Clinic/Group Practice 3779873708 Receives reassigned benefits from 14 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

5751 Blythewood St
Ste 100
Houston, TX 77021
Phone (713) 747-2500

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1013230788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SOUTHMORE AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775021307",
            "telephone_number": "713-944-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 BLYTHEWOOD ST",
            "address_2": "STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770215402",
            "telephone_number": "281-593-3300",
            "fax_number": "281-593-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC DENTISTRY OLD SPANISH TRAIL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "JABBARY",
        "authorized_official_first_name": "ARMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-944-6800",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210698101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC DENTAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ABC DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.