Provider Demographics
NPI:1558371831
Name:AKKAS, ABDULLAH (DDS)
Entity Type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:
Last Name:AKKAS
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 1:2161 SEBASTIAN WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3214
Mailing Address - Country:US
Mailing Address - Phone:916-791-7860
Mailing Address - Fax:
Practice Address - Street 1:940 COLUSA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3629
Practice Address - Country:US
Practice Address - Phone:530-755-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist