Provider Demographics
NPI:1588045843
Name:ABDULKADIR, SINAN (BDS, DMD)
Entity Type:Individual
Prefix:DR
First Name:SINAN
Middle Name:
Last Name:ABDULKADIR
Suffix:
Gender:M
Credentials:BDS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 ESPERANZA XING APT 421
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-7866
Mailing Address - Country:US
Mailing Address - Phone:512-367-3423
Mailing Address - Fax:
Practice Address - Street 1:717 HIGHWAY 71 W
Practice Address - Street 2:SUITE 300
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4063
Practice Address - Country:US
Practice Address - Phone:512-501-4176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX309351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice