Provider Demographics
NPI:1376158352
Name:ABUELENIN, SAMA (DMD)
Entity Type:Individual
Prefix:
First Name:SAMA
Middle Name:
Last Name:ABUELENIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 REBEL RUN DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2638
Mailing Address - Country:US
Mailing Address - Phone:347-286-9181
Mailing Address - Fax:
Practice Address - Street 1:2909 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1513
Practice Address - Country:US
Practice Address - Phone:732-707-6654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02810100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist