Provider Demographics
NPI:1447098918
Name:ANBARI, MOHAMMAD AREF (DDS)
Entity type:Individual
Prefix:
First Name:MOHAMMAD AREF
Middle Name:
Last Name:ANBARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 NEWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1079
Mailing Address - Country:US
Mailing Address - Phone:681-285-8307
Mailing Address - Fax:
Practice Address - Street 1:212 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9697
Practice Address - Country:US
Practice Address - Phone:724-225-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0447491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice