Individual provider Active NPI

Ali Dlair Abdulmajeed

  • General Practice Dentistry
  • Laveen, AZ
National Provider Identifier
1194493080
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011932 Issued in AZ
Practice address
5045 W Baseline Rd Ste 135
Laveen, AZ 85339-7394
Phone
(602) 237-0613
NPI assigned
Sep 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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 019033385 IL
General Practice Dentistry 1223G0001X D011932 AZ Primary

Addresses

Primary practice location

5045 W Baseline Rd Ste 135
Laveen, AZ 85339-7394

Mailing address

450 E Waterside Dr Unit 704
Chicago, IL 60601-4708
Phone (832) 373-2721

Other practice location 1

2314 N Milwaukee Ave
Chicago, IL 60647-2925
Phone (773) 697-3164

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

State licenses

LicenseStateTypeSpecialty
D011932AZMDGeneral Practice Dentistry
019033385ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Laveen Modern Dentistry PastSince Sep 10, 2023 Accepting new patients
Brite Dental Milwaukee, P.C. PastSince Sep 1, 2021 Accepting new patients
Laveen Modern Dentistry, LLP General Practice PastSince Sep 10, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1194493080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E WATERSIDE DR UNIT 704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014708",
            "telephone_number": "832-373-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 W BASELINE RD STE 135",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397394",
            "telephone_number": "602-237-0613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2314 N Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606472925",
            "country_code": "US",
            "telephone_number": "773-697-3164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULMAJEED",
        "first_name": "ALI",
        "middle_name": "DLAIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033385",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.