Individual provider Active NPI

Alabbas Hussain, DMD

  • Endodontics
  • Hawthorne, CA
National Provider Identifier
1790200160
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10957 Issued in NC
Practice address
4277 W El Segundo Blvd
Hawthorne, CA 90250-4548
Phone
(310) 970-0900
NPI assigned
Aug 7, 2017
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101809 CA
Endodontics 1223E0200X 10957 NC Primary

Addresses

Primary practice location

4277 W El Segundo Blvd
Hawthorne, CA 90250-4548

Mailing address

572 Sandhurst Dr
Fayetteville, NC 28304-4426
Phone (910) 485-3636

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

LicenseStateTypeSpecialty
101809CAMDDentist
10957NCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Suren Paravyan, DMD, MD, MSD, PA Endodontics CurrentSince Apr 3, 2022 Accepting new patients
Alabbas Hussain DMD PLLC Endodontics Current Accepting new patients
Heydar Shahrokh DDS Inc Dentist Past Accepting new patients

Locations

572 Sandhurst Dr
Fayetteville, NC 28304
Phone (910) 485-3636

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1790200160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044426",
            "telephone_number": "910-485-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 W EL SEGUNDO BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902504548",
            "telephone_number": "310-970-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "ALABBAS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2017-08-07",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101809",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "10957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.