Active NPI
Abbas Haider, D.D.S.
- General Practice Dentistry
- Decatur, GA
National Provider Identifier
1245432004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11863
- Practice address
- 3521 Memorial Dr
Suite a
Decatur, GA 30032-2731 - Phone
- (404) 557-2921
- Fax
- (404) 567-8487
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 11863 | GA | Primary |
| General Practice Dentistry | 1223G0001X | 7511 | TN |
Addresses
Primary practice location
3521 Memorial Dr
Suite a
Decatur, GA 30032-2731
Mailing address
3521 Memorial Dr
Suite a
Decatur, GA 30032-2731
Phone (404) 557-2921
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 |
|---|---|---|---|
| 7511 | TN | MD | Speech-Language Pathologist |
| 11863 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326931200000",
"number": "1245432004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3521 MEMORIAL DR",
"address_2": "SUITE A",
"city": "DECATUR",
"state": "GA",
"postal_code": "300322731",
"telephone_number": "404-557-2921",
"fax_number": "404-567-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3521 MEMORIAL DR",
"address_2": "SUITE A",
"city": "DECATUR",
"state": "GA",
"postal_code": "300322731",
"telephone_number": "404-557-2921",
"fax_number": "404-567-8487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIDER",
"first_name": "ABBAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2012-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "11863",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "7511",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.