Provider Demographics
NPI:1154050185
Name:ABDALLA, NOOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOOR
Middle Name:
Last Name:ABDALLA
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 1:31 RIVER CT APT 2405
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2032
Mailing Address - Country:US
Mailing Address - Phone:810-394-0607
Mailing Address - Fax:
Practice Address - Street 1:711 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-5833
Practice Address - Country:US
Practice Address - Phone:201-437-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016013841223G0001X
NJ22DI029645001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice