Individual provider Active NPI

Abdullah Akkad

  • General Practice Dentistry
  • Cincinnati, OH
National Provider Identifier
1124752860
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.027760 Issued in OH
Practice address
3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399
Phone
(513) 454-1111
NPI assigned
Jul 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.027760 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399

Mailing address

3802 Paxton Ave Ste 12a
Cincinnati, OH 45209-2399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731003600 OH Order and Referring Only - DentistPractitioner - Dentist 2860900982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1124752860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 PAXTON AVE STE 12A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 PAXTON AVE STE 12A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092399",
            "telephone_number": "513-454-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKKAD",
        "first_name": "ABDULLAH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-09",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027760",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.