Nicolas Fawzi Abujamra, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

4873-015 Issued in WI

Practice address

2581 Development Dr
Suite 102
Green Bay, WI 54311-4247

Phone

(920) 347-2626

Fax

(920) 347-2621

NPI assigned

Feb 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Oct 31, 2016 through Oct 31, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Nicolas Abujamra DDS Ms LTD

  • Prosthodontics
  • Green Bay, WI
  • NPI 1841419587
  NPD (past) Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720123201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2581 DEVELOPMENT DR",
            "address_2": "SUITE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114247",
            "telephone_number": "920-347-2626",
            "fax_number": "920-347-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 DEVELOPMENT DR",
            "address_2": "SUITE 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114247",
            "telephone_number": "920-347-2626",
            "fax_number": "920-347-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABUJAMRA",
        "first_name": "NICOLAS",
        "middle_name": "FAWZI",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4873-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Joseph Abfall, DDS
• Amber M Abraham, PA-C
• Clayton Edward Abts, MS LPC
• Jade Catherine Abts, NP
• Tianna Abts
• Abundant Health Chiropractic, LLC
• Abundant Life Chiropractic LLC
• Abundant Life Counseling & Renewal Center LLC
• Academic Maternal-Fetal Medicine Consultants SC
• Access Prosthetics LLC

• Dentist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.