Active NPI
Wakas S. Abdulrazzaq, D.M.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- Wesley Chapel, FL
National Provider Identifier
1871014001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN28972
- 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, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 019031122 | IL | MD | General Practice Dentistry |
| DN28972 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 17615 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 0401416743 | VA | MD | Orthodontics 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.