Active NPI
Ibraheem George Ackall, DDS
- Dentist
- Alamogordo, NM
National Provider Identifier
1598867368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD2887
- Practice address
- 2150 Highway 54 S
Alamogordo, NM 88310-7330 - Phone
- (575) 443-8133
- Fax
- (575) 443-8055
- NPI assigned
- Sep 2, 2006
- Last updated
- Nov 12, 2009
- 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 | DD2887 | NM | Primary |
Addresses
Primary practice location
2150 Highway 54 S
Alamogordo, NM 88310-7330
Mailing address
PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60602775 | Medicaid | NM |
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 |
|---|---|---|---|
| DD2887 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1598867368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 370",
"city": "HATCH",
"state": "NM",
"postal_code": "879370370",
"telephone_number": "575-267-3280",
"fax_number": "575-267-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2150 HIGHWAY 54 S",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "883107330",
"telephone_number": "575-443-8133",
"fax_number": "575-443-8055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKALL",
"first_name": "IBRAHEEM",
"middle_name": "GEORGE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD2887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "60602775",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alamogordo, NM
- Barbara Bernucci Abalos, BCBA
- Lexus Abeita-Madrigal
- Ferial Abood, MD
- Muawia Suffyan Baker Abujaber, M.D.
- Access Home Health, LLC
- Acp Pharmacy LLC (ACP Pharmacy)
- Acp Pharmacy LLC (Alamogordo Community Pharmacy)
- Acp Pharmacy LLC (Alamogordo Community Pharmacy)
- Acp RX LLC (Alamogordo Community Pharmacy)
- Alexandria Adams
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.