Active NPI
Amine Kaddour-Djebbar
- Dentist
- Laredo, TX
National Provider Identifier
1477082519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33062
- Practice address
- 7807 McPherson Rd
Laredo, TX 78045-2813 - Phone
- (832) 495-1643
- NPI assigned
- Jun 11, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 33062 | TX | Primary |
Addresses
Primary practice location
7807 McPherson Rd
Laredo, TX 78045-2813
Mailing address
14919 Twisting Oak St
Houston, TX 77082
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 |
|---|---|---|---|
| 33062 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brush Dental PLLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Missouri City, TX
- NPI 1609542323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497571200000",
"number": "1477082519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14919 TWISTING OAK ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7807 MCPHERSON RD",
"city": "LAREDO",
"state": "TX",
"postal_code": "780452813",
"telephone_number": "832-495-1643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADDOUR-DJEBBAR",
"first_name": "AMINE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-11",
"last_updated": "2017-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "33062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.