Active NPI
Nicholas Michael Abdallah, DDS
- Dentist
- Woodhaven, MI
National Provider Identifier
1225567688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901022235
- Practice address
- 21080 Allen Road
Woodhaven, MI 48183 - Phone
- (586) 255-1141
- NPI assigned
- Jun 8, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022235 | MI | Primary |
Addresses
Primary practice location
21080 Allen Road
Woodhaven, MI 48183
Mailing address
21080 Allen Rd
Woodhaven, MI 48183-1602
Phone (586) 255-1141
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 |
|---|---|---|---|
| 2901022235 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1225567688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21080 ALLEN RD",
"city": "WOODHAVEN",
"state": "MI",
"postal_code": "481831602",
"telephone_number": "586-255-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21080 ALLEN ROAD",
"city": "WOODHAVEN",
"state": "MI",
"postal_code": "48183",
"telephone_number": "586-255-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDALLAH",
"first_name": "NICHOLAS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901022235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodhaven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.