Individual provider Active NPI

Abdulaziz Faisal Dudeen, DDS

  • Dentist
  • Bryan, TX
National Provider Identifier
1386990950
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28315 Issued in TX
Practice address
1601 N Texas Ave
Ste 150
Bryan, TX 77803-1858
Phone
(979) 778-6010
NPI assigned
Jul 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28315 TX Primary

Addresses

Primary practice location

1601 N Texas Ave
Ste 150
Bryan, TX 77803-1858

Mailing address

1601 N Texas Ave
Ste 150
Bryan, TX 77803-1858
Phone (979) 778-6010

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
28315TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1386990950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N TEXAS AVE",
            "address_2": "STE 150",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778031858",
            "telephone_number": "979-778-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N TEXAS AVE",
            "address_2": "STE 150",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778031858",
            "telephone_number": "979-778-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEEN",
        "first_name": "ABDULAZIZ",
        "middle_name": "FAISAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.