Active NPI
Mustafa Aldabbagh, DMD
- General Practice Dentistry
- College Station, TX
National Provider Identifier
1033959549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40606
- Practice address
- 1530 Texas Ave S Ste 300
College Station, TX 77840-3390 - Phone
- (346) 247-1277
- NPI assigned
- May 31, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 40606 | TX | Primary |
Addresses
Primary practice location
1530 Texas Ave S Ste 300
College Station, TX 77840-3390
Mailing address
344 Santa Fe CT Apt 344
Hamilton, NJ 08619-2072
Phone (346) 247-1277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40606 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1033959549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 SANTA FE CT APT 344",
"city": "HAMILTON",
"state": "NJ",
"postal_code": "086192072",
"telephone_number": "346-247-1277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 TEXAS AVE S STE 300",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778403390",
"telephone_number": "346-247-1277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALDABBAGH",
"first_name": "MUSTAFA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "40606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.