Individual provider Active NPI

Abdalrahman Gaber Mohamed Abdallah

  • Dentist
  • Merced, CA
National Provider Identifier
1184588923
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
112582 Issued in CA
Practice address
1124 W Olive Ave Ste 101
Merced, CA 95348-1939
Phone
(209) 205-4288
NPI assigned
Dec 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 112582 CA Primary

Addresses

Primary practice location

1124 W Olive Ave Ste 101
Merced, CA 95348-1939

Mailing address

2140 Morning Star LN
Winston Salem, NC 27107-6241
Phone (510) 401-0022

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

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1184588923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 MORNING STAR LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271076241",
            "telephone_number": "510-401-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 W OLIVE AVE STE 101",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481939",
            "telephone_number": "209-205-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED ABDALLAH",
        "first_name": "ABDALRAHMAN GABER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "112582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.