ODAI ABUSHANAB DMD NPI 1053818302

NPI Information

  • NPI: 1053818302
  • Provider Name: ODAI ABUSHANAB, DMD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 110 BERGEN ST
    NEWARK, NJ
    ZIP 07103
  • Phone: (973) 972-3126

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NPI Details

Odai Abushanab, DMD is an oral and maxillofacial surgery dentist in Newark, NJ with 8 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Odai Abushanab, DMD NPI is 1053818302. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: M H KORNBERG SCHOOL OF DENTISTRY, TEMPLE UNIVERSITY
Graduation Year:2018

The provider's business location address is:

110 BERGEN ST
NEWARK, NJ
ZIP 07103-495
Phone: (973) 972-3126

The NPI 1053818302 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/11/2018 and was last updated on 6/4/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
21223S0112XDentistOral and Maxillofacial Surgery22DI02760901NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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