Provider Demographics
NPI:1487012910
Name:ABDELMEGEED, PASSANT (DMD)
Entity Type:Individual
Prefix:DR
First Name:PASSANT
Middle Name:
Last Name:ABDELMEGEED
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 1:5 KERRIGAN WAY
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 BEACON ST
Practice Address - Street 2:SUITE #300
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-7786
Practice Address - Country:US
Practice Address - Phone:617-566-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1857097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist