Individual provider Active NPI

Mary Abdou, DMD

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1689805939
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5802 Issued in NV
Practice address
7945 W Sahara Ave Ste 101
Las Vegas, NV 89117-7908
Phone
(702) 363-0421
NPI assigned
Aug 5, 2009
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5802 NV Primary

Addresses

Primary practice location

7945 W Sahara Ave Ste 101
Las Vegas, NV 89117-7908

Mailing address

7945 W Sahara Ave Ste 101
Las Vegas, NV 89117-7908
Phone (702) 612-7714

Other identifiers 1

IdentifierTypeStateIssuer
1689805939MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160802002325 NV Order and Referring Only - DentistPractitioner - Dentist 0244524080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5802NVMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Avitia DDS, LLC Past Accepting new patients

Organizations & group practices 1

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": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1689805939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 W SAHARA AVE STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177908",
            "telephone_number": "702-612-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 W SAHARA AVE STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177908",
            "telephone_number": "702-363-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDOU",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "5802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689805939",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.