Tara Aboumahboub, DMD
Individual provider Active NPI Dentist · Cincinnati, OH
NPI 1831760487 · NPPES record last updated Jul 6, 2021
Key facts
- NPI
- 1831760487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 30.026572 (OH)
- Practice address
- 425 Walnut St Ste 201
Cincinnati, OH 45202-3939 - Phone
- (561) 866-6692
- NPI assigned
- Jul 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26134 | FL | MD | Dentist |
| DN26134 | FL | MD | Dentist |
| 30.026572 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN26134 | FL | |
| Dentist | 122300000X | 26134 | FL | |
| Dentist | 122300000X | 30.026572 | OH | Yes |
Addresses
Primary practice location
425 Walnut St Ste 201
Cincinnati, OH 45202-3939
Mailing address
721 Main St Apt 805
Cincinnati, OH 45202-3665
Phone (561) 866-6692
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.