Provider Demographics
NPI:1043665706
Name:KIBRIA, MAHEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHEEN
Middle Name:
Last Name:KIBRIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2020
Mailing Address - Country:US
Mailing Address - Phone:845-270-4581
Mailing Address - Fax:
Practice Address - Street 1:161 NEW BRUNSWICK AVE STE 203
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2370
Practice Address - Country:US
Practice Address - Phone:732-884-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027581001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry