Individual provider Active NPI

Abdulrahman Chahbandar

  • Dentist
  • Gainesville, FL
National Provider Identifier
1255063038
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN27020 Issued in FL
Practice address
1395 Center Dr
Gainesville, FL 32610-1213
Phone
(352) 273-5800
NPI assigned
Jun 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 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 30.026924 OH
Dentist 122300000X DN27020 FL Primary

Addresses

Primary practice location

1395 Center Dr
Gainesville, FL 32610-1213

Mailing address

12603 Rain Forest St
Temple Terrace, FL 33617-1382
Phone (813) 451-1432

Other practice location 1

3421 South Blvd
Columbus, OH 43204-1213
Phone (614) 272-0110

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Computer Direct
CONNECT URL Computer Direct

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
DN27020FLMDDentist
30.026924OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Dentist PastSince Jul 23, 2023 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1255063038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12603 RAIN FOREST ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336171382",
            "telephone_number": "813-451-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CENTER DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326101213",
            "telephone_number": "352-273-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3421 South Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432041213",
            "country_code": "US",
            "telephone_number": "614-272-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAHBANDAR",
        "first_name": "ABDULRAHMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026924",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3421 South Blvd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432041213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1395 Center Dr",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326103006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.