Nevin Shenouda Abdelmalak, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

D13700 Issued in MN

Practice address

508 S Harbor Blvd
Fullerton, CA 92832-2411

Phone

(651) 216-2175

NPI assigned

May 24, 2016

Last updated

Mar 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northland Dental Partners, PLLC

  dba Cedar Bend Dental Care

  • General Practice Dentistry
  • Coon Rapids, MN
  • NPI 1740938166
  NPD (past)

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1104273705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 GREENWICH DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331206",
            "telephone_number": "651-216-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322411",
            "telephone_number": "651-216-2175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13040 Riverdale Dr NW",
            "address_2": "#600",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554488406",
            "country_code": "US",
            "telephone_number": "763-323-3042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2430 Greenwich Dr",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928331206",
            "country_code": "US",
            "telephone_number": "651-216-2175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDELMALAK",
        "first_name": "NEVIN",
        "middle_name": "SHENOUDA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103378",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaithleen Nicole Masa Abastillas
• Daniel Abbott, MD
• Ishraq H Abdalla
• Nivein Ahmed Abdelaziz
• Mohamad Bashar Abdelfattah, MD
• Suhaila Abdu
• Emi Abe
• Patricia H Abella
• Lincoln Abellanosa
• Nader Abolhosn

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.