Abdelnaser Mustafa Elmahdi, B.D.S D.D.S

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN014893 Issued in GA

Practice address

1944 Braselton Hwy Ste 107
Buford, GA 30519-3033

Phone

(770) 696-9450

NPI assigned

Nov 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Abdelnaser Mustafa Mohamed Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Douglasville Dental Associates, P.C.

  • General Practice Dentistry
  • Douglasville, GA
  • NPI 1639353964
  NPD (past)

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1770737488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 BRASELTON HWY STE 107",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305193033",
            "telephone_number": "770-696-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 BRASELTON HWY STE 107",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305193033",
            "telephone_number": "770-696-9450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9579 Highway 5 Ste 701",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351574",
            "country_code": "US",
            "telephone_number": "770-400-0019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9579 Highway 5",
            "address_2": "Suite 700",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301351574",
            "country_code": "US",
            "telephone_number": "770-942-2852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELMAHDI",
        "first_name": "ABDELNASER",
        "middle_name": "MUSTAFA",
        "name_prefix": "Dr.",
        "credential": "B.D.S  D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020810",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27542",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2109642",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "RESIDENT AT MCG",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN014893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABDELNASER",
            "last_name": "MOHAMED",
            "middle_name": "MUSTAFA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Prosthodontics in Buford, GA
• Providers in Buford, GA by specialty
• Prosthodontics in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.