Active NPI
Alaa H Abu Sabaa, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1649623935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DL12976
- Practice address
- 360 E South Water St Apt 3505
Chicago, IL 60601-4146 - Phone
- (571) 451-4809
- NPI assigned
- Jul 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.031947 | IL | |
| Dentist | 122300000X | DL12976 | MA | Primary |
Addresses
Primary practice location
360 E South Water St Apt 3505
Chicago, IL 60601-4146
Mailing address
360 E South Water St Apt 3505
Chicago, IL 60601-4146
Phone (571) 451-4809
Other practice location 1
1000 Blythe Blvd
CMC Dental Clinic
Charlotte, NC 28203-5812
Phone (704) 335-2165
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031947 | IL | MD | Dentist |
| DL12976 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1649623935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 E SOUTH WATER ST APT 3505",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606014146",
"telephone_number": "571-451-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 E SOUTH WATER ST APT 3505",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606014146",
"telephone_number": "571-451-4809"
}
],
"practiceLocations": [
{
"address_1": "1000 Blythe Blvd",
"address_2": "CMC Dental Clinic",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035812",
"country_code": "US",
"telephone_number": "704-335-2165",
"fax_number": "704-355-8856",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABU SABAA",
"first_name": "ALAA",
"middle_name": "H",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.031947",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DL12976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.