Osama Aboulkhair, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9755 Issued in SC

Practice address

2123 Broad River Rd
Columbia, SC 29210-7007

Phone

(703) 438-0060

NPI assigned

Nov 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Oz Aboulkhair Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1053916064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SWEET THORNE RD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290638312",
            "telephone_number": "703-438-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107007",
            "telephone_number": "703-438-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOULKHAIR",
        "first_name": "OSAMA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OZ",
            "last_name": "ABOULKHAIR",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Columbia, SC
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.