Pamela Abraham, DMD
Individual provider Active NPI Dentist · Inglewood, CA
NPI 1710131362 · NPPES record last updated Nov 10, 2008
Key facts
- NPI
- 1710131362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 57863 (CA)
- Practice address
- 300 E Buckthorn St
Inglewood, CA 90301-3418 - Phone
- (617) 838-7559
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20151222000968 | CA | Order and Referring Only - Dentist |
9436450178 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57863 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 57863 | CA | Yes |
Addresses
Primary practice location
300 E Buckthorn St
Inglewood, CA 90301-3418
Mailing address
300 E Buckthorn St
Inglewood, CA 90301-3418
Phone (617) 838-7559
Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2008. 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.