NPIMap

Organization Active NPI

Robert M Abraham, D.D.S., P.a.

  • General Practice Dentistry
  • Vicksburg, MS
National Provider Identifier
1962523944
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1513-72 Issued in MS
Legal business name
ROBERT M ABRAHAM, D.D.S., P.A.
Practice address
1909 Mission 66
Vicksburg, MS 39180-3711
Phone
(601) 638-9111
Fax
(601) 638-0013
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Authorized official

Name
Dr. Robert M Abraham Sr., D.D.S.NPI 1851603260
Title
President
Phone
(601) 638-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1513-72 MS Primary

Addresses

Primary practice location

1909 Mission 66
Vicksburg, MS 39180-3711

Mailing address

PO Box 820089
Vicksburg, MS 39182-0089
Phone (601) 638-9111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278979200000",
    "number": "1962523944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820089",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391820089",
            "telephone_number": "601-638-9111",
            "fax_number": "601-638-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-638-9111",
            "fax_number": "601-638-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M ABRAHAM, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-07-13",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-638-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "1513-72",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.