Provider Demographics
NPI:1043247026
Name:ABDULLAH, ASLIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASLIM
Middle Name:
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 1:14333 LAUREL BOWIE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708
Mailing Address - Country:US
Mailing Address - Phone:301-776-1030
Mailing Address - Fax:301-776-0657
Practice Address - Street 1:1443 LAUREL BOWIE RD
Practice Address - Street 2:STE 300
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708
Practice Address - Country:US
Practice Address - Phone:301-776-1030
Practice Address - Fax:301-776-0657
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD80691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0046325060Medicare UPIN