Active NPI
George Abdelnour, D.D.S.
- Dentist
- Muskogee, OK
National Provider Identifier
1194959296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6247
- Practice address
- 615 W Shawnee Bypass
Muskogee, OK 74401 - Phone
- (918) 351-7135
- NPI assigned
- May 5, 2009
- Last updated
- Dec 12, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D5874 | OR | |
| Dentist | 122300000X | 6247 | OK | Primary |
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| D5874 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Estate of Kevin L. Chancellor | General Practice | Past | Accepting new patients |
| Lakeside Family Dentistry | General Practice | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lakeside Family Dentistry
- General Practice Dentistry
- Lincoln City, OR
- NPI 1518106228
-
- General Practice Dentistry
- Lincoln City, OR
- NPI 1982198719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576108800000",
"number": "1194959296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3173 W DEVILS LAKE RD",
"city": "LINCOLN CITY",
"state": "OR",
"postal_code": "97367",
"telephone_number": "541-994-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 W SHAWNEE BYPASS",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "74401",
"telephone_number": "918-351-7135"
}
],
"practiceLocations": [
{
"address_1": "3173 W Devils Lake Rd",
"address_purpose": "LOCATION",
"city": "Lincoln City",
"state": "OR",
"postal_code": "97367",
"country_code": "US",
"telephone_number": "541-994-8135",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDELNOUR",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-05",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D5874",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.