Provider Demographics
NPI:1598442097
Name:ABEDINI SURGICAL GROUP LLC
Entity Type:Organization
Organization Name:ABEDINI SURGICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMBOD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEDINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:301-337-8294
Mailing Address - Street 1:3640 CONCORD PIKE # 1151
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-5022
Mailing Address - Country:US
Mailing Address - Phone:301-337-8294
Mailing Address - Fax:
Practice Address - Street 1:3640 CONCORD PIKE # 1151
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-5022
Practice Address - Country:US
Practice Address - Phone:301-337-8294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty