Ragaa Abdulmoniem, DDS
Individual provider Active NPI General Practice Dentistry · Bristol, TN
NPI 1114758331 · NPPES record last updated Aug 9, 2024
Key facts
- NPI
- 1114758331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12604 (TN)
- Practice address
- 1401 Volunteer Pkwy Apt 3
Bristol, TN 37620-6009 - Phone
- (423) 217-6300
- NPI assigned
- Aug 9, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates of East Tennessee PLLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12604 | TN | Yes |
Addresses
Primary practice location
1401 Volunteer Pkwy Apt 3
Bristol, TN 37620-6009
Mailing address
266 Mockingbird LN Apt 503
Johnson City, TN 37604-3167
Phone (703) 568-0451
Other providers in Bristol, TN
- A Loving Hand Home Care Services
- Felecia Gail Abdelfattah
- Anisa Abdosh
- Seth Patrick Achey
- Annalee Adams
- Emily Adams
- Stephanie Ann Adams
- Tyler Jackson Adams
All providers in Bristol, TN · General Practice Dentistry in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.