Amin Abdallah, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

S3-328C Issued in NV

Practice address

1350 Kelso Dunes Ave Apt 315
Henderson, NV 89014-7826

Phone

(510) 673-5130

NPI assigned

Oct 31, 2016

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roseman University of Health Sciences

  • Local Education Agency (LEA)
  • Henderson, NV
  • NPI 1366681777
  NPD (past)

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1013469584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 KELSO DUNES AVE APT 315",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 KELSO DUNES AVE APT 315",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147826",
            "telephone_number": "510-673-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "AMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3-328C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Iyabode Abah
• Holly Abarca
• Sandy Abarca
• Denise Abbott
• Sofia Abdala
• Mohammad Abdelhady
• Soudabeh Abdi, FNP
• Laurie Abdo
• Arthur Abdoulin, D.M.D.
• Christine Abdulkarim, RD

• Orthodontics and Dentofacial Orthopedics Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.