Individual provider Active NPI

Abdelhamed Abdelrahman Tamara, D.D.S.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1902812134
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049557 Issued in NY
Practice address
466 78TH St
First Floor
Brooklyn, NY 11209-3404
Phone
(718) 491-6585
Fax
(718) 491-6586
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049557 NY Primary

Addresses

Primary practice location

466 78TH St
First Floor
Brooklyn, NY 11209-3404

Mailing address

466 78TH St.
First Floor
Brooklyn, NY 11209
Phone (718) 491-6585

Other identifiers 1

IdentifierTypeStateIssuer
02207734MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160208000007 NY Order and Referring Only - DentistPractitioner - Dentist 6709180094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049557NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902812134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 78TH ST.",
            "address_2": "FIRST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-491-6585",
            "fax_number": "718-491-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 78TH ST",
            "address_2": "FIRST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093404",
            "telephone_number": "718-491-6585",
            "fax_number": "718-491-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMARA",
        "first_name": "ABDELHAMED",
        "middle_name": "ABDELRAHMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02207734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.