Elias Kamal Abdi, DDS

Individual provider Active NPI Pediatric Dentistry · Frederick, MD

NPI 1912496993 · NPPES record last updated Dec 13, 2023

Key facts

NPI: 1912496993
Entity type: Individual (NPI type 1)
Primary specialty: Pediatric Dentistry 1223P0221X
License: 16676 (MD)
Practice address: 7360 Guilford Dr Ste 102
Frederick, MD 21704-5128
Phone: (301) 668-2662
NPI assigned: May 6, 2018
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

North Star Pediatric Dentistry Pediatric Dentistry · Maple Grove, MN · NPI 1902775786

NPD PEDIATRIC DENTISTRY

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
North Star Pediatric Dentistry	Pediatric Dentistry	Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatric Dentistry	1223P0221X	16676	MD	Yes
Dentist	122300000X	16676	MD

Addresses

Primary practice location

7360 Guilford Dr Ste 102
Frederick, MD 21704-5128

Mailing address

7360 Guilford Dr Ste 102
Frederick, MD 21704-5128
Phone (301) 668-2662

Other identifiers

Identifier	Type	State	Issuer
913115900	Medicaid	MD

Other providers in Frederick, MD

All providers in Frederick, MD · Pediatric Dentistry in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2023. 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.

Verify at the official NPI Registry.