Provider Demographics
NPI:1871374520
Name:ABID, NOOR ABDULHASSAB
Entity type:Individual
Prefix:
First Name:NOOR
Middle Name:ABDULHASSAB
Last Name:ABID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30722 VERIDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5859
Mailing Address - Country:US
Mailing Address - Phone:202-763-2633
Mailing Address - Fax:
Practice Address - Street 1:30722 VERIDIAN WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5859
Practice Address - Country:US
Practice Address - Phone:202-763-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL284371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice