Provider Demographics
NPI:1447899943
Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:
Authorized Official - Last Name:JBARAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-820-7113
Mailing Address - Street 1:2285 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7214
Mailing Address - Country:US
Mailing Address - Phone:717-334-2223
Mailing Address - Fax:
Practice Address - Street 1:2285 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7214
Practice Address - Country:US
Practice Address - Phone:717-334-2223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE & BEYOND FAMILY DENTISTRY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1124517040Medicaid