Provider Demographics
NPI:1871222950
Name:ABDULLAH, SAMMY HASSAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:HASSAN
Last Name:ABDULLAH
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 1:604 W EULESS BLVD
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4429
Mailing Address - Country:US
Mailing Address - Phone:940-249-9089
Mailing Address - Fax:
Practice Address - Street 1:1600 2ND AVE SW STE 21
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3459
Practice Address - Country:US
Practice Address - Phone:701-839-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11960122300000X
ND2491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist