Active NPI
Brigida Momand Abdelnaby, DDS
- Dentist
- San Pedro, CA
National Provider Identifier
1306123369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36179
- Practice address
- 1441 W 8TH St
San Pedro, CA 90732-3803 - Phone
- (310) 832-5295
- NPI assigned
- Nov 4, 2011
- Last updated
- Oct 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36179 | CA | Primary |
Addresses
Primary practice location
1441 W 8TH St
San Pedro, CA 90732-3803
Mailing address
26764 Shadow Wood Dr
Rancho Palos Verdes, CA 90275-2351
Phone (310) 791-3327
Other practice location 1
19000 Hawthorne Blvd
suite 400
Torrance, CA 90503-1517
Phone (310) 539-5045
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36179 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572307200000",
"number": "1306123369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26764 SHADOW WOOD DR",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902752351",
"telephone_number": "310-791-3327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 W 8TH ST",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907323803",
"telephone_number": "310-832-5295"
}
],
"practiceLocations": [
{
"address_1": "19000 Hawthorne Blvd",
"address_2": "suite 400",
"address_purpose": "LOCATION",
"city": "Torrance",
"state": "CA",
"postal_code": "905031517",
"country_code": "US",
"telephone_number": "310-539-5045",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDELNABY",
"first_name": "BRIGIDA",
"middle_name": "MOMAND",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-04",
"last_updated": "2019-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.