Nabil Rene Ibrahim, B.D.S., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19668 Issued in MA

Practice address

10 Converse PL
Winchester, MA 01890

Phone

(781) 729-1159

Fax

(781) 756-0900

NPI assigned

Aug 13, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nabil R. Ibrahim B.D.S., D.D.S., PLLC

  • Dental Clinic/Center
  • Winchester, MA
  • NPI 1720560543
  NPD (past) Authorized official

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1073526117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONVERSE PL STE 102",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902713",
            "telephone_number": "781-729-1159",
            "fax_number": "781-756-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONVERSE PL",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "01890",
            "telephone_number": "781-729-1159",
            "fax_number": "781-756-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "NABIL",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "B.D.S., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Elizabeth Huber, DMD
• Melanie Hudson
• Crystal Hume, RD LDN
• Kelsey Hunter, PA-C
• John J Hutcheson, M.D.
• Impact Health Alliance LLC
• Sonia Amaral Inacio, MD
• Insight Recovery Treatment Center LLC
• Richard Irving, MSW
• Jackie Surdan, LMHC, LLC

• General Practice Dentistry in Winchester, MA
• Providers in Winchester, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.