Individual provider Active NPI

Usama Saad Farhan Al Abdullah, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Garner, NC
National Provider Identifier
1790429082
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
14096 Issued in NC
Practice address
12450 Cleveland Rd Ste 100
Garner, NC 27529-8355
Phone
(919) 772-9927
Fax
(919) 772-0647
NPI assigned
Apr 23, 2022
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 14096 NC Primary

Addresses

Primary practice location

12450 Cleveland Rd Ste 100
Garner, NC 27529-8355

Mailing address

12450 Cleveland Rd Ste 100
Garner, NC 27529-8355
Phone (919) 772-9927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417003590 NC Order and Referring Only - DentistPractitioner - Dentist 6002331410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14096NCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lane & Associates DDS Xvii PA General Practice CurrentSince Apr 6, 2025 Accepting new patients

Locations

12450 Cleveland School Rd
Ste 100
Garner, NC 27529
Phone (919) 639-2020

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1790429082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 CLEVELAND RD STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298355",
            "telephone_number": "919-772-9927",
            "fax_number": "919-772-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 CLEVELAND RD STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275298355",
            "telephone_number": "919-772-9927",
            "fax_number": "919-772-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL ABDULLAH",
        "first_name": "USAMA",
        "middle_name": "SAAD FARHAN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-23",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "14096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.