Nada Abdallah
Individual provider Active NPI Dentist · Chicago, IL
NPI 1144847740 · NPPES record last updated Jun 30, 2020
Key facts
- NPI
- 1144847740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 36197 (TX)
- Practice address
- 801 S Paulina St
Chicago, IL 60612-7210 - Phone
- (409) 344-1680
- NPI assigned
- Jun 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36197 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36197 | TX | Yes |
Addresses
Primary practice location
801 S Paulina St
Chicago, IL 60612-7210
Mailing address
1405 Avenue L
Nederland, TX 77627-4463
Phone (409) 344-1680
NPI Registry JSON
{
"created_epoch": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1144847740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 AVENUE L",
"city": "NEDERLAND",
"state": "TX",
"postal_code": "776274463",
"telephone_number": "409-344-1680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "409-344-1680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDALLAH",
"first_name": "NADA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-30",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2020. 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.