Moutaz Abdeen, DDS
Individual provider Active NPI Dentist · Richmond, VA
NPI 1285795153 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285795153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401410287 (VA)
- Practice address
- 9030 Three Chopt Rd
Suite a
Richmond, VA 23229-4641 - Phone
- (804) 282-7011
- Fax
- (804) 282-7082
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201231001484 | DC | Practitioner - Dentist |
4789097007 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401410287 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George a Oley III DDS PLC | Dentist | Past |
Accepting new patients |
| George a Oley III PLC | Dentist | Past | Accepting new patients |
| Alexandria Smile Dentistry, PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401410287 | VA | Yes |
Addresses
Primary practice location
9030 Three Chopt Rd
Suite a
Richmond, VA 23229-4641
Mailing address
9030 Three Chopt Rd
Suite a
Richmond, VA 23229-4641
Phone (804) 282-7011
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.