Individual provider Active NPI

Danny Abboud, DDS

  • General Practice Dentistry
  • Boulder, CO
National Provider Identifier
1285811679
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN9598 Issued in CO
Practice address
1610 Canyon Blvd
Boulder, CO 80302-5407
Phone
(303) 442-5000
Fax
(303) 442-4396
NPI assigned
Jan 28, 2008
Last updated
May 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN9598 CO Primary

Addresses

Primary practice location

1610 Canyon Blvd
Boulder, CO 80302-5407

Mailing address

1610 Canyon Blvd
Boulder, CO 80302-5407
Phone (303) 442-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001732 CO Order and Referring Only - DentistPractitioner - Dentist 8426359589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN9598COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Dental Center Table Mesa PC Current Accepting new patients
Englewood Dental Center PC PastSince Dec 9, 2019 Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1285811679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 CANYON BLVD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025407",
            "telephone_number": "303-442-5000",
            "fax_number": "303-442-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 CANYON BLVD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025407",
            "telephone_number": "303-442-5000",
            "fax_number": "303-442-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOUD",
        "first_name": "DANNY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-28",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN9598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.