Individual provider Active NPI

Dina Aboushehata, DDS

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1124616768
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00204618 Issued in CO
Practice address
1705 N Weber St
Colorado Springs, CO 80907-7503
Phone
(719) 471-1900
NPI assigned
Jan 8, 2021
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00204618 CO Primary

Addresses

Primary practice location

1705 N Weber St
Colorado Springs, CO 80907-7503

Mailing address

2210 Calistoga Dr
Colorado Springs, CO 80915-4365
Phone (970) 829-2798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00204618COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
North End Dental, PLLC CurrentSince Jan 10, 2021 Accepting new patients

Locations

1705 N Weber St
Colorado Springs, CO 80907
Phone (719) 417-1900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1124616768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 CALISTOGA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809154365",
            "telephone_number": "970-829-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 N WEBER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077503",
            "telephone_number": "719-471-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOUSHEHATA",
        "first_name": "DINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.