Peter Abude, D.D.S
Individual provider Active NPI General Practice Dentistry · Highland, CA
NPI 1497196117 · NPPES record last updated Dec 22, 2020
Key facts
- NPI
- 1497196117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 62541 (CA)
- Practice address
- 28895 Greenspot Rd Unit 103
Highland, CA 92346-5770 - Phone
- (909) 280-5342
- Fax
- (909) 566-0138
- NPI assigned
- Jul 10, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151217002409 | CA | Order and Referring Only - Dentist |
2668773532 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62541 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abude Dental Corporation | General Practice | Current |
Accepting new patients |
Locations
28895 Greenspot Rd
Ste 103
Highland, CA 92346
Phone (909) 280-5342
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62541 | CA | Yes |
Addresses
Primary practice location
28895 Greenspot Rd Unit 103
Highland, CA 92346-5770
Mailing address
28895 Greenspot Rd Unit 103
Highland, CA 92346-5770
Phone (909) 280-5342
Other names
- Dr. Peter Obiajuru Abude
Other providers in Highland, CA
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- Abcd Primary and Urgent Care Inc
- Amin S. Abdelmeseeh
- Olajuwon Abijo
- Abude Dental Corporation
- Access Services Clinical Research
- Joy Adeyemo
- Omotayo Joseph Ajayi
- Mayadah Albeer
- Albertsons LLC
All providers in Highland, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.