CMS-1500 Box 24J / 33a • NPI
1073008959
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
1223P0221X
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
1789 NW 173RD AVE, BEAVERTON, OR, 97006-4817
✓ 9-Digit EDI 837 ZIP+4 (97006-4817)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1073008959 (MARWA ALY ABDELHAMID ABDELRAHMAN, BDS, MSD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1073008959 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MARWA ALY ABDELHAMID ABDELRAHMAN, BDS, MSD |
| Plain-English Specialty | Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: 1223P0221X (Dentist, Pediatric Dentistry) |
| Certifying / Licensing Body | American Dental Association (ADA) / State Board of Dental Examiners |
| Practice Location Address | 1789 NW 173RD AVE, BEAVERTON, OR, 97006-4817 |
| Practice Telephone / Fax | Tel: (503) 614-1177 |
| Administrative Mailing Address | 15144 NW COSMOS ST, PORTLAND, OR, 97229-7058 |
| Enumeration & Last Sync | Enumerated: 2018-06-24 | CMS Record Updated: 2023-02-11 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (1223P0221X)
What Does Taxonomy Code 1223P0221X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223P0221X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MARWA ALY ABDELHAMID ABDELRAHMAN, BDS, MSD)
Typical CPT / Diagnostic Procedures:- Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
- Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
- Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
- Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
390200000X — Student in an Organized Health Care Education/Training ProgramPlain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program | State: N/A | License: Verified | Primary: Secondary |
1223P0221X — Dentist, Pediatric DentistryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: OR | License: D11695 | Primary: Yes (Primary) |
1223G0001X — Dentist, General PracticePlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: OH | License: 30.026292 | Primary: Secondary |
1223P0221X — Dentist, Pediatric DentistryPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: OH | License: 30.026292 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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