Active NPI
Mariam Samir Abadir
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1376197848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 103976
- Practice address
- 1670 Westwood Dr. Suite K
San Jose, CA 95125 - Phone
- (408) 826-4676
- NPI assigned
- Aug 1, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 103976 | CA | Primary |
Addresses
Primary practice location
1670 Westwood Dr. Suite K
San Jose, CA 95125
Mailing address
620 Iris Ave Apartment #320
Sunnyvale, CA 94086
Other names 1
- Dr. Mariam Samir Abadir
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 |
|---|---|---|---|
| 103976 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1376197848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 IRIS AVE APARTMENT #320",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "94086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 WESTWOOD DR. SUITE K",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95125",
"telephone_number": "408-826-4676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABADIR",
"first_name": "MARIAM",
"middle_name": "SAMIR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "103976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIAM",
"last_name": "ABADIR",
"middle_name": "SAMIR",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.