Mohamad Hassan Rabah, BDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401419120 Issued in VA

Practice address

450 Garrisonville Rd Ste 201
Stafford, VA 22554-1615

Phone

(540) 720-1222

NPI assigned

May 22, 2023

Last updated

Aug 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sebastian M Bouroncle DDS-2 Stafford PLLC

  dba New Smiles Dental Stafford

  • General Practice Dentistry
  • Stafford, VA
  • NPI 1073057741
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1801588769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 S STATE HIGHWAY 121",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750675920",
            "telephone_number": "972-693-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 GARRISONVILLE RD STE 201",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541615",
            "telephone_number": "540-720-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABAH",
        "first_name": "MOHAMAD HASSAN",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401419120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Stafford, VA
• Providers in Stafford, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.