Provider Demographics
NPI:1477641256
Name:ABAIE, ABRAHAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:ABAIE
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 1:6949 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6146
Mailing Address - Country:US
Mailing Address - Phone:480-818-8204
Mailing Address - Fax:
Practice Address - Street 1:6949 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6146
Practice Address - Country:US
Practice Address - Phone:480-818-8204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0459211223G0001X
AZD69311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice