Provider Demographics
NPI:1467206284
Name:ABDI, FAIZA IBRAHIM (DENTURIS)
Entity Type:Individual
Prefix:
First Name:FAIZA
Middle Name:IBRAHIM
Last Name:ABDI
Suffix:
Gender:F
Credentials:DENTURIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30918 32ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7874
Mailing Address - Country:US
Mailing Address - Phone:253-221-1162
Mailing Address - Fax:
Practice Address - Street 1:30818 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4902
Practice Address - Country:US
Practice Address - Phone:253-839-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61261106122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist