Active NPI
Marcus Abboud, DDS
- Prosthodontics
- Stony Brook, NY
National Provider Identifier
1730432303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 000032
- Practice address
- 1104 Westchester HL
Stony Brook, NY 11794-8706 - Phone
- (631) 632-9371
- NPI assigned
- Oct 19, 2012
- Last updated
- Oct 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 000032 | NY | Primary |
Addresses
Primary practice location
1104 Westchester HL
Stony Brook, NY 11794-8706
Mailing address
11 Club House CT
Setauket, NY 11733-1041
Phone (631) 388-2372
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000032 | NY | MD | Dance Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350604800000",
"number": "1730432303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CLUB HOUSE CT",
"city": "SETAUKET",
"state": "NY",
"postal_code": "117331041",
"telephone_number": "631-388-2372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 WESTCHESTER HL",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117948706",
"telephone_number": "631-632-9371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABBOUD",
"first_name": "MARCUS",
"name_prefix": "Prof.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-19",
"last_updated": "2012-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "000032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.