Individual provider Active NPI

Ali Obeidi, DDS, M.SC., MS.

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1306071378
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24443 Issued in TX
Practice address
11507 Olympia Dr
Houston, TX 77077-6421
Phone
(281) 610-0284
NPI assigned
May 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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 0401416018 VA
General Practice Dentistry 1223G0001X 24443 TX Primary

Addresses

Primary practice location

11507 Olympia Dr
Houston, TX 77077-6421

Mailing address

11507 Olympia Dr
Houston, TX 77077-6421
Phone (281) 610-0284

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
24443TXMDGeneral Practice Dentistry
0401416018VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentvance Dental Care Current Accepting new patients
Ali Obeidi DDS PLLC CurrentSince Sep 17, 2023 Accepting new patients

Organizations & group practices 2

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1306071378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11507 OLYMPIA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770776421",
            "telephone_number": "281-610-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11507 OLYMPIA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770776421",
            "telephone_number": "281-610-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEIDI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DDS, M.SC., MS.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-20",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416018",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.