Active NPI
Wijdan Dabeek
- Dentist
- Odessa, TX
National Provider Identifier
1992481923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 39607
- Practice address
- 2260 Linda Ave Ste 103
Odessa, TX 79763-2665 - Phone
- (432) 614-2246
- NPI assigned
- Jun 26, 2023
- Last updated
- Jun 26, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 39607 | TX | Primary |
Addresses
Primary practice location
2260 Linda Ave Ste 103
Odessa, TX 79763-2665
Mailing address
243 Palisades Dr
Morgantown, WV 26508-9009
Phone (304) 777-6450
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 |
|---|---|---|---|
| 39607 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1992481923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 PALISADES DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265089009",
"telephone_number": "304-777-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 LINDA AVE STE 103",
"city": "ODESSA",
"state": "TX",
"postal_code": "797632665",
"telephone_number": "432-614-2246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DABEEK",
"first_name": "WIJDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "39607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.