Individual provider Active NPI

Elham Abbassi, D.D.S

  • Dentist
  • Houston, TX
National Provider Identifier
1124183512
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20466 Issued in TX
Practice address
2617 W Holcombe Blvd Ste I
Houston, TX 77025
Phone
(832) 862-1111
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 20466 TX
Dentist 122300000X 20466 TX Primary

Addresses

Primary practice location

2617 W Holcombe Blvd Ste I
Houston, TX 77025

Mailing address

2623 Havencrest Dr
Pearland, TX 77584-9139
Phone (832) 515-6685

Other practice location 1

5800 Bellaire Blvd Ste 110
Houston, TX 77081-5537
Phone (713) 667-4077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 12, 2019 through Dec 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20466TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brident Dental Associates PC Dentist Past Accepting new patients
Athena Dental Associates of Houston, Inc. Durable Medical Equipment & Medical Supplies Past Accepting new patients
South Texas Dental Associates, L.P. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1124183512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 HAVENCREST DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775849139",
            "telephone_number": "832-515-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 W HOLCOMBE BLVD STE I",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77025",
            "telephone_number": "832-862-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5800 Bellaire Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770815537",
            "country_code": "US",
            "telephone_number": "713-667-4077",
            "fax_number": "713-667-4281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBASSI",
        "first_name": "ELHAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "20466",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.