CMS-1500 Box 24J / 33a • NPI
1366603987
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
122300000X (CMS C5)
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
3600 W TECUMSEH RD, NORMAN, OK, 73072-1840
✓ 9-Digit EDI 837 ZIP+4 (73072-1840)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1366603987 (ELIE ABOU NASSAR, DDS) 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
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
No
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1366603987)
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amoxicillin Amoxicillin | 74 | 56 |
| Chlorhexidine Gluconate Chlorhexidine Gluconate | 11 | <11 |
| Clindamycin Hcl Clindamycin Hcl | 16 | 12 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 28 | 25 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1366603987 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ELIE ABOU NASSAR, DDS |
| Plain-English Specialty | Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: 122300000X (Dentist) |
| Certifying / Licensing Body | American Dental Association (ADA) / State Board of Dental Examiners |
| Practice Location Address | 3600 W TECUMSEH RD, NORMAN, OK, 73072-1840 |
| Practice Telephone / Fax | Tel: (405) 701-3111 | Fax: (405) 701-2524 |
| Administrative Mailing Address | 3600 W TECUMSEH RD, NORMAN, OK, 73072-1840 |
| Enumeration & Last Sync | Enumerated: 2008-06-17 | CMS Record Updated: 2024-03-13 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (122300000X)
What Does Taxonomy Code 122300000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 122300000X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ELIE ABOU NASSAR, DDS)
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 |
|---|---|
1223G0001X — Dentist, General PracticePlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: OK | License: 6017 | Primary: Secondary |
122300000X — DentistPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: OK | License: 6017 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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