Individual provider Active NPI

Mehboob Gulamali Abdullah, DDS

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1184899692
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.023108 Issued in OH
Practice address
2500 Metrohealth Drive
Cleveland, OH 44109-1998
Phone
(216) 778-4737
Fax
(216) 778-8875
NPI assigned
Apr 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
General Practice Dentistry 1223G0001X 30.023108 OH Primary

Addresses

Primary practice location

2500 Metrohealth Drive
Cleveland, OH 44109-1998

Mailing address

2500 Metrohealth Drive
Cleveland, OH 44109-1998
Phone (216) 778-4737

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
I20161215000806 OH Order and Referring Only - DentistPractitioner - Dentist 3779863436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.023108OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1184899692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DRIVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091998",
            "telephone_number": "216-778-4737",
            "fax_number": "216-778-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DRIVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091998",
            "telephone_number": "216-778-4737",
            "fax_number": "216-778-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLAH",
        "first_name": "MEHBOOB",
        "middle_name": "GULAMALI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.