George Abdelnour, D.D.S.
Individual provider Active NPI Dentist · Muskogee, OK
NPI 1194959296 · NPPES record last updated Dec 12, 2019
Key facts
- NPI
- 1194959296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6247 (OK)
- Practice address
- 615 W Shawnee Bypass
Muskogee, OK 74401 - Phone
- (918) 351-7135
- NPI assigned
- May 5, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| D5874 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Family Dentistry | General Practice | Past | Accepting new patients |
| Estate of Kevin L. Chancellor | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D5874 | OR | |
| Dentist | 122300000X | 6247 | OK | Yes |
Addresses
Primary practice location
615 W Shawnee Bypass
Muskogee, OK 74401
Mailing address
3173 W Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-8135
Other practice location 1
3173 W Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-8135
Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2019. 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.