NPIMap

Organization Active NPI

Tam N Issa-Abbas LLC

Doing business as Capital City Dental

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1821415746
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30023476 Issued in OH
Legal business name
TAM N ISSA-ABBAS LLC
Doing business as
Capital City Dental
Practice address
79 Thurman Ave
Columbus, OH 43206-2685
Phone
(614) 443-4625
Fax
(614) 443-6558
NPI assigned
Mar 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Dr. Tam Ngoc Issa-Abbas, D.D.S.
Title
President/Owner
Phone
(614) 537-5061

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30023476 OH Primary

Addresses

Primary practice location

79 Thurman Ave
Columbus, OH 43206-2685

Mailing address

79 Thurman Ave
Columbus, OH 43206-2685
Phone (614) 443-4625

Other identifiers 1

IdentifierTypeStateIssuer
0082242MedicaidOH

Other names 1

  • CAPITAL CITY DENTAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Gentle Smiles2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1821415746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 THURMAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062685",
            "telephone_number": "614-443-4625",
            "fax_number": "614-443-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 THURMAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062685",
            "telephone_number": "614-443-4625",
            "fax_number": "614-443-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAM N ISSA-ABBAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "ISSA-ABBAS",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "614-537-5061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30023476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAPITAL CITY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.