Individual provider Active NPI

Abdullah Mahmud Mahmud, DDS

  • General Practice Dentistry
  • Fraser, MI
National Provider Identifier
1053802660
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901022621 Issued in MI
Practice address
33080 Garfield Rd
Fraser, MI 48026-1867
Phone
(586) 293-8750
NPI assigned
May 21, 2018
Last updated
May 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901022621 MI Primary

Addresses

Primary practice location

33080 Garfield Rd
Fraser, MI 48026-1867

Mailing address

26460 Westphal St Apt 119
Dearborn Heights, MI 48127-3777
Phone (704) 918-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807003820 MI Order and Referring Only - DentistPractitioner - Dentist 0648528612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abdullah Mahmud DDS PLLC Current Accepting new patients
DCF Limited, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1053802660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 WESTPHAL ST APT 119",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273777",
            "telephone_number": "704-918-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33080 GARFIELD RD",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480261867",
            "telephone_number": "586-293-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMUD",
        "first_name": "ABDULLAH",
        "middle_name": "MAHMUD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fraser, MI

Sources for this page

Verify at the official NPI Registry.