Individual provider Active NPI

Abubeker Beshir Mohammednur, DMD

  • General Practice Dentistry
  • Brookings, OR
National Provider Identifier
1700733946
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12301 Issued in OR
Practice address
648 Chetco Ave Ste 2
Brookings, OR 97415-8010
Phone
(541) 216-4469
NPI assigned
Mar 16, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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 D12301 OR Primary

Addresses

Primary practice location

648 Chetco Ave Ste 2
Brookings, OR 97415-8010

Mailing address

4511 SW Luradel St Apt B
Portland, OR 97219-6832
Phone (503) 926-3107

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

LicenseStateTypeSpecialty
D12301ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1700733946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 SW LURADEL ST APT B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196832",
            "telephone_number": "503-926-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 CHETCO AVE STE 2",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974158010",
            "telephone_number": "541-216-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMMEDNUR",
        "first_name": "ABUBEKER",
        "middle_name": "BESHIR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D12301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.