Individual provider · NPI-1
Omar Abdelbaky, DDS, MD
Oral & Maxillofacial Surgery · Keller, TX
NPI number1669827184
StatusActive
Last updated in NPPESSep 28, 2024
Details
- NPI
- 1669827184
- Entity type
- Individual (NPI-1)
- Name
- Omar Abdelbaky
- Credential
- DDS, MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2016
- Certification date
- Sep 28, 2024
- Last updated
- Sep 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 204E00000X | Oral & Maxillofacial Surgery | 36948 | TX | Yes |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 36948 | TX | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 2022-00732 | NC | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | T6489 | TX | |
| 204E00000X | Oral & Maxillofacial Surgery | T6489 | TX | |
| 204E00000X | Oral & Maxillofacial Surgery | 12196 | NC | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 12196 | NC | |
| 204E00000X | Oral & Maxillofacial Surgery | 2022-00732 | NC | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1141 Keller Pkwy Ste BKeller, TX 76248-1628
Phone 817-518-6246
Mailing address
4414 Lovers LnDallas, TX 75225-6923
Other practice locations
4414 Lovers Ln
Dallas, TX 75225-6923
Dallas, TX 75225-6923
Phone 469-809-6858
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