Individual provider Active NPI

Ahmed Abdelhadi, DDS

  • General Practice Dentistry
  • Rock Hill, SC
National Provider Identifier
1528635638
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1858998 Issued in MA
Practice address
128 Herlong Ave S Ste 102
Rock Hill, SC 29732-1156
Phone
(803) 825-4815
NPI assigned
Jun 7, 2021
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DGD10295 SC
General Practice Dentistry 1223G0001X DN1858998 MA Primary

Addresses

Primary practice location

128 Herlong Ave S Ste 102
Rock Hill, SC 29732-1156

Mailing address

4403 Stagecoach Rd
Stoughton, MA 02072-1780
Phone (617) 230-5116

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
DN1858998MAMDGeneral Practice Dentistry
DGD10295SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oz Dental Services Current Accepting new patients
Avon First Dental LLC PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1528635638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 STAGECOACH RD",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721780",
            "telephone_number": "617-230-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 HERLONG AVE S STE 102",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321156",
            "telephone_number": "803-825-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELHADI",
        "first_name": "AHMED",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-07-18",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD10295",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.