Provider Demographics
NPI:1871334326
Name:SALIM, ABDULHAFIDH TALIB (DDS)
Entity type:Individual
Prefix:DR
First Name:ABDULHAFIDH
Middle Name:TALIB
Last Name:SALIM
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 1:14225 SHARPSHINNED DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-5833
Mailing Address - Country:US
Mailing Address - Phone:571-488-8309
Mailing Address - Fax:
Practice Address - Street 1:921 E MAIN ST # C
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3133
Practice Address - Country:US
Practice Address - Phone:540-441-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014189771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice