Randy Abdou, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DDS104531 Issued in CA

Practice address

327 3Rd St
Ramona, CA 92065-2401

Phone

(760) 789-8537

NPI assigned

May 17, 2018

Last updated

Oct 25, 2022By the provider in NPPES

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

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1083104780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 MORRIS AVE APT 1004",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104682896",
            "telephone_number": "619-890-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 3RD ST",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920652401",
            "telephone_number": "760-789-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDOU",
        "first_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ramona, CA
• Providers in Ramona, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.