Abdelrahman Alaa Eldin Labib Mohamed, DDS
Individual provider Active NPI Dentist · Manchester, NH
NPI 1740700129 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1740700129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 04326 (NH)
- Practice address
- 801 Elm St
Manchester, NH 03101-2103 - Phone
- (603) 623-7800
- NPI assigned
- Jun 26, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- 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 |
|---|---|---|---|---|
| I20171017001832 | NH | Order and Referring Only - Other (Physician) |
6406122589 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 42 North Dental Care, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 04326 | NH | Yes |
Addresses
Primary practice location
801 Elm St
Manchester, NH 03101-2103
Mailing address
801 Elm St
Manchester, NH 03101-2103
Phone (603) 623-7800
Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.