Individual provider Active NPI

Selma Ghassan Mahmoud

  • Dentist
  • Austin, TX
National Provider Identifier
1295469278
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38437 Issued in TX
Practice address
6500 N Mopac Expy Ste 2204
Austin, TX 78731-3282
Phone
(512) 489-9933
NPI assigned
Jul 14, 2022
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38437 TX Primary

Addresses

Primary practice location

6500 N Mopac Expy Ste 2204
Austin, TX 78731-3282

Mailing address

11900 Deering PL
Austin, TX 78726-4101
Phone (512) 825-7163

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
38437TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1295469278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 DEERING PL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787264101",
            "telephone_number": "512-825-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 N MOPAC EXPY STE 2204",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313282",
            "telephone_number": "512-489-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUD",
        "first_name": "SELMA",
        "middle_name": "GHASSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.