Provider Demographics
NPI:1548596570
Name:NEDAB, MITCHELL F (DDS)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:F
Last Name:NEDAB
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 1:729 8TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2823
Mailing Address - Country:US
Mailing Address - Phone:202-546-2202
Mailing Address - Fax:
Practice Address - Street 1:729 8TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2823
Practice Address - Country:US
Practice Address - Phone:202-546-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1000863122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist