Provider Demographics
NPI:1508965583
Name:ATA-ABADI, KAMRAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:
Last Name:ATA-ABADI
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 1:20801 NO SCOTTSDALE RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255
Mailing Address - Country:US
Mailing Address - Phone:480-513-2773
Mailing Address - Fax:480-513-0666
Practice Address - Street 1:20801 NO SCOTTSDALE RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255
Practice Address - Country:US
Practice Address - Phone:480-513-2773
Practice Address - Fax:480-513-0666
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist