Provider Demographics
NPI:1225801046
Name:R ABEDI DDS PLLC
Entity Type:Organization
Organization Name:R ABEDI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-288-5955
Mailing Address - Street 1:209 W APACHE TRL
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-3910
Mailing Address - Country:US
Mailing Address - Phone:480-288-5955
Mailing Address - Fax:480-288-4345
Practice Address - Street 1:209 W APACHE TRL
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3910
Practice Address - Country:US
Practice Address - Phone:480-288-5955
Practice Address - Fax:480-288-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty