Individual provider Active NPI

Wakas S. Abdulrazzaq, D.M.D

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wesley Chapel, FL
National Provider Identifier
1871014001
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN28972 Issued in FL
Practice address
3751 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9201
Phone
(813) 575-1008
NPI assigned
Jun 28, 2017
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019031122 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401416743 VA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 17615 MD
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN28972 FL Primary

Addresses

Primary practice location

3751 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9201

Mailing address

2420 14TH St NW Apt 531
Washington, DC 20009-3754
Phone (443) 224-0737

Other practice location 1

2420 14th St NW Apt 531
Washington, DC 20009-3754
Phone (443) 224-0737

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
019031122ILMDGeneral Practice Dentistry
DN28972FLMDOrthodontics and Dentofacial Orthopedic Dentist
17615MDMDOrthodontics and Dentofacial Orthopedic Dentist
0401416743VAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1871014001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 14TH ST NW APT 531",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200093754",
            "telephone_number": "443-224-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335449201",
            "telephone_number": "813-575-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 14th St NW Apt 531",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200093754",
            "country_code": "US",
            "telephone_number": "443-224-0737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULRAZZAQ",
        "first_name": "WAKAS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031122",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401416743",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "17615",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN28972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.