Individual provider Active NPI

Lina Kamal Abideen, DDS

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1700442571
Registry record updated Aug 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061269 Issued in NY
Practice address
2376 Broadway
New York, NY 10024-2801
Phone
(212) 686-3686
NPI assigned
May 16, 2019
Last updated
Aug 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 061269 NY Primary

Addresses

Primary practice location

2376 Broadway
New York, NY 10024-2801

Mailing address

22 Jones St Apt 2D
New York, NY 10014-4141
Phone (718) 724-4966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190821000434 NY Order and Referring Only - DentistPractitioner - Dentist 0840528469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061269NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1700442571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 JONES ST APT 2D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144141",
            "telephone_number": "718-724-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242801",
            "telephone_number": "212-686-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABIDEEN",
        "first_name": "LINA",
        "middle_name": "KAMAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.