Individual provider Active NPI

Mohamed Abdel Moneim a M Abbass, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1801181102
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27012 Issued in TX
Practice address
9208 E R L Thornton Fwy
209-B
Dallas, TX 75228-6104
Phone
(214) 321-8383
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27012 TX Primary

Addresses

Primary practice location

9208 E R L Thornton Fwy
209-B
Dallas, TX 75228-6104

Mailing address

9208 E R L Thornton Fwy
209-B
Dallas, TX 75228-6104
Phone (214) 321-8383

Other identifiers 1

IdentifierTypeStateIssuer
2966202-01MedicaidTX

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
27012TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1801181102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9208 E R L THORNTON FWY",
            "address_2": "209-B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286104",
            "telephone_number": "214-321-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9208 E R L THORNTON FWY",
            "address_2": "209-B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286104",
            "telephone_number": "214-321-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASS",
        "first_name": "MOHAMED",
        "middle_name": "ABDEL MONEIM A M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2966202-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.