Andrew Elias Abide Sr., D.M.D.

Individual provider Active NPI General Practice Dentistry · Greenville, MS

NPI 1154469443 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154469443
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1957-82 (MS)
Practice address
637 Rayner Rd
Greenville, MS 38701-8135
Phone
(662) 378-8606
Fax
(662) 378-8690
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1957-82MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew E Abide DMD PA General Practice Past Accepting new patients
Dental Group of Greenville Past
since Sep 20, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1957-82 MS Yes

Addresses

Primary practice location

637 Rayner Rd
Greenville, MS 38701-8135

Mailing address

637 Rayner Rd
Greenville, MS 38701-8135
Phone (662) 378-8606

Other providers in Greenville, MS

All providers in Greenville, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.