Provider Demographics
NPI:1184842304
Name:YAHYA, MUJTABA MOHAMMED (DDS)
Entity Type:Individual
Prefix:DR
First Name:MUJTABA
Middle Name:MOHAMMED
Last Name:YAHYA
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 1:9105 ALL SAINTS RD STE O
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1750
Mailing Address - Country:US
Mailing Address - Phone:301-776-6666
Mailing Address - Fax:301-776-1858
Practice Address - Street 1:9105 ALL SAINTS RD STE O
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1750
Practice Address - Country:US
Practice Address - Phone:301-776-6666
Practice Address - Fax:301-776-1858
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD131151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice