Alexander Abboud, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

065276 Issued in NY

Practice address

4981 W Genesee St
Camillus, NY 13031-2313

Phone

(315) 487-3335

NPI assigned

Dec 30, 2025

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tag Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Camillus, NY
  • NPI 1316725096

  Orthodontics and Dentofacial Orthopedics

  NPD

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

{
    "created_epoch": "1767052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1740146166",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "34 GLENNIE DRIVE",
            "city": "AJAX",
            "state": "ONTARIO",
            "postal_code": "L1T5A4"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4981 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312313",
            "telephone_number": "315-487-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOUD",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "065276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Abbamont, MD
• Jamie Abear
• Lisa Marie Adornato, RPH
• Lisa Marie Adrian, LMT
• Advance Physical Therapy
• Aesthetic Plastic Surgery of Syracuse PLLC

• All providers in Camillus, NY
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.