Provider Demographics
NPI:1295184927
Name:ABUOUDEH, FARQAD KAMAL (DDS)
Entity type:Individual
Prefix:DR
First Name:FARQAD
Middle Name:KAMAL
Last Name:ABUOUDEH
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 1:1901 CALLE DE NINOS
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3293
Mailing Address - Country:US
Mailing Address - Phone:575-526-6622
Mailing Address - Fax:
Practice Address - Street 1:1901 CALLE DE NINOS
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-3293
Practice Address - Country:US
Practice Address - Phone:575-526-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD54411223G0001X
TX321811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice