Joe W Abdelnour, DDS MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D4537 Issued in AZ

Practice address

1467 Palma Road
Suite 3
Bullhead City, AZ 86442

Phone

(928) 763-1203

Fax

(928) 758-1072

NPI assigned

Jun 24, 2006

Last updated

Nov 21, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• River Rock Oral Surgery, LLC

  • Dental Clinic/Center
  • Bullhead City, AZ
  • NPI 1235530379
  NPD (past)

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1013943612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 PALMA RD",
            "address_2": "SUITE 1",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-763-1203",
            "fax_number": "928-758-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 PALMA ROAD",
            "address_2": "SUITE 3",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86442",
            "telephone_number": "928-763-1203",
            "fax_number": "928-758-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELNOUR",
        "first_name": "JOE",
        "middle_name": "W",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D4537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAHCCS",
            "identifier": "34223B",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aban Wellness Care
• Aban Wellness Care
• Abc Therapy
• Abc Therapy, Inc.
• Abc Therapy, Inc.
• Andrew Acevedo
• Courtney Acton, PHARM D
• Affordable Dentures & Implants - Bullhead City V, P.C.
• Sandra E Aguayo, PA
• Mohamed S Ahmed, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.