Individual provider Active NPI

Omar K Mahmassani, D.D.S.

  • Dentist
  • Frederick, MD
National Provider Identifier
1497781850
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10913 Issued in MD
Practice address
5910 Frederick Crossing LN Ste 101
Frederick, MD 21704-5141
Phone
(301) 662-4422
Fax
(301) 965-8360
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 10913 MD
Dentist 122300000X 10913 MD Primary

Addresses

Primary practice location

5910 Frederick Crossing LN Ste 101
Frederick, MD 21704-5141

Mailing address

5910 Frederick Crossing LN
Suite 101
Frederick, MD 21704-5112
Phone (301) 662-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260623004590 MD Practitioner - Dentist 5991025280 Practice locations: Frederick, MD
O20170322001702 MD DME Supplier - Physician - General Practice 5698050292 Practice locations: Frederick, MD

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Georgetown University School of Medicine, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1150 Primrose Dr
Roswell, GA 30076-4217

1325 Bridge Mill Ave
Canton, GA 30114-7762

5910 Frederick Crossing LN
Frederick, MD 21704-5141
Phone (301) 662-4422

5910 Frederick Crossing LN
Suite 101
Frederick, MD 21704-5112

5910 Frederick Crossing LN
Suite 101
Frederick, MD 21704-5185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10913MDMDCustomized Equipment (DME)

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1497781850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 FREDERICK CROSSING LN",
            "address_2": "SUITE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217045112",
            "telephone_number": "301-662-4422",
            "fax_number": "301-965-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 FREDERICK CROSSING LN STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217045141",
            "telephone_number": "301-662-4422",
            "fax_number": "301-965-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMASSANI",
        "first_name": "OMAR",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MD",
            "license": "10913",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "10913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.