Active NPI
Nagwan Ibrahim
- General Practice Dentistry
- Greenville, TX
National Provider Identifier
1073297792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 39484
- Practice address
- 8110 Wesley St Ste 100
Greenville, TX 75402-3936 - Phone
- (903) 458-6819
- NPI assigned
- Jun 13, 2023
- Sex
- Female
- 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 | 39484 | TX | Primary |
Addresses
Primary practice location
8110 Wesley St Ste 100
Greenville, TX 75402-3936
Mailing address
5800 N Interstate 35 Ste 205
Denton, TX 76207-1438
Phone (940) 220-7833
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 |
|---|---|---|---|
| 39484 | TX | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1073297792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 N INTERSTATE 35 STE 205",
"city": "DENTON",
"state": "TX",
"postal_code": "762071438",
"telephone_number": "940-220-7833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8110 WESLEY ST STE 100",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754023936",
"telephone_number": "903-458-6819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "NAGWAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-13",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "39484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.