Sally Abouassaf, DDS
Individual provider Active NPI General Practice Dentistry · Parker, CO
NPI 1659677805 · NPPES record last updated Feb 7, 2011
Key facts
- NPI
- 1659677805
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10377 (CO)
- Practice address
- 11005 S Parker Rd
Parker, CO 80134-7441 - Phone
- (303) 805-3588
- Fax
- (303) 805-0743
- NPI assigned
- Feb 7, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20170504000371 | TX | Order and Referring Only - Dentist |
0749567543 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10377 | CO | MD | General Practice Dentistry |
| 30508 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10377 | CO | Yes |
Addresses
Primary practice location
11005 S Parker Rd
Parker, CO 80134-7441
Mailing address
11005 S Parker Rd
Parker, CO 80134-7441
Phone (303) 805-3588
Other providers in Parker, CO
- Aae Investments Inc
- Aasha LLC
- ABA at Legacy
- Galia Regina Abadi
- Michael Abadia
- Danielle Abrahams
- Amber Abrams
- Absolute Total Home Care, Inc
- Accord Surgical Assisting
- Akaash Acharya
All providers in Parker, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2011. 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.